Surgical platform with adjustable arm supports

ABSTRACT

A robotic surgical system can include one or more adjustable arm supports that support one or more robotic arms. The adjustable arm supports can be configured to attach to either a table, a column support of the table, or a base of the table to deploy the adjustable arm supports and robotic arms from a position below the table. In some examples, the adjustable arm supports include at least four degrees of freedom that allow for adjustment of the position of a bar or rail to which the robotic arms are mounted. One of the degrees of freedom can allow the adjustable arm support to be adjusted vertically relative to the table.

INCORPORATION BY REFERENCE TO ANY PRIORITY APPLICATIONS

This application claims priority to U.S. Provisional Application No.62/618,489, filed Jan. 17, 2018, which is incorporated herein byreference. Any and all applications for which a foreign or domesticpriority claim is identified in the Application Data Sheet as filed withthe present application are hereby incorporated by reference under 37CFR 1.57.

BACKGROUND Field

This description generally relates to medical systems, and particularlyto a surgical or medical platform, table, or bed with adjustable armsupports.

Description

Robotic technologies have a range of applications. In particular,robotic arms help complete tasks that a human would normally perform.For example, factories use robotic arms to manufacture automobiles andconsumer electronics products. Additionally, scientific facilities userobotic arms to automate laboratory procedures such as transportingmicroplates. Recently, physicians have started using robotic arms tohelp perform surgical procedures. For instance, physicians use roboticarms to control surgical instruments inside a patient. However, existingmedical systems including robotic arms have a high capital cost and aretypically specialized to perform limited types of surgical procedures.Thus, physicians or their assistants may need to obtain multiple roboticarm systems to accommodate a range of surgical procedures. Manuallyreconfiguring a robotic arm system for each surgical procedure is alsotime-consuming and physically demanding for the physicians.

SUMMARY

A surgical (or medical) robotics system with robotic arms isconfigurable to perform a variety of surgical (or medical) procedures. Arobotic surgical system can include one or more adjustable arm supportsthat support one or more robotic arms. The adjustable arm supports canbe configured to attach to either a table, a column support of thetable, or a base of the table to deploy the adjustable arm supports androbotic arms from a position below the table. In some examples, theadjustable arm supports include at least four degrees of freedom thatallow for adjustment of the position of a bar or rail to which therobotic arms are mounted. One of the degrees of freedom can allow theadjustable arm support to be adjusted vertically relative to the table.A robotic surgical system can include two adjustable arm supports, eachsupporting one or more robotic arms. The two adjustable arm supports canbe independently adjusted. For example, each arm support can be adjustedto a different height relative to the table.

In a first aspect, a system can include a table configured to support apatient. The system can also include a column extending along a firstaxis between a first end and a second end. The first end can be coupledto the table. A base can be coupled to the second end of the column. Thesystem can include a first arm support coupled to at least one of thetable, column or the base by at least a first joint configured to allowadjustment along the first axis relative to the table. The first armsupport can include a first bar having a proximal portion and a distalportion extending along a second axis different from the first axis. Thefirst bar can be configured to support at least one robotic arm.

The system can include one or more of the following features in anycombination: (a) wherein the first axis is a vertical axis and the firstjoint is configured to allow adjustment of the first bar in a verticaldirection; (b) wherein the first joint comprises a motorized linearjoint configured to move along the first axis; (c) a first robotic armmounted to the first bar, the first robotic arm configured to translatealong the second axis; (d) a second robotic arm mounted to the firstbar, the second robotic arm configured to translate along the secondaxis; (e) wherein the second robotic arm is configured to translatealong the second axis independently of the first robotic arm; (f) athird robotic arm mounted to the first bar; (g) wherein at least one ofthe first robotic arm, second robotic arm or third robotic arm holds acamera; (h) wherein at least one of the first robotic arm, secondrobotic arm or third robotic arm can be stowed under the table; (i)wherein the first arm support comprises a second joint configured toadjust a tilt angle of the first bar; (j) wherein the second jointcomprises a motorized rotational joint configured to rotate around athird axis that is different than the first axis; (k) wherein the firstarm support comprises a third joint and a bar connector, the barconnector mechanically coupling the first bar with the third joint; (l)wherein the third joint comprises a motorized rotational jointconfigured to pivot the bar connector about a fourth axis that isdifferent than the first axis; (m) wherein the third joint is configuredto pivot the bar connector to adjust a positioning of the first barrelative to the column; (n) wherein: the third joint is positioned at afirst end of the bar connector, the first end of the bar connectorcoupled to the column, an additional joint is positioned at a second endof the bar connector, the second end of the bar connector coupled to thefirst bar, and the additional joint is mechanically constrained to thethird joint such that the additional joint and the third joint rotatetogether; (o) wherein the additional joint is mechanically constrainedto the third joint via a four-bar linkage; (p) wherein the additionaljoint is mechanically constrained to the third joint such that anorientation of the first bar does not change as the bar connectorpivots; (q) wherein the first bar is capable of translation along alength of the table such that the first bar can extend beyond an end ofthe table; (r) wherein the first bar is further coupled to the column byat least one fourth joint configured to allow translation of the firstbar relative to the column along the second axis; (s) wherein the firstarm support is configured to be positioned on a first side of the table,and wherein the system further comprises a second arm support coupled toat least one of the table, column or base and configured to bepositioned on a second side of the table; (t) wherein the second side isopposite the first side; (u) wherein the second arm support comprises asecond bar extending along a fifth axis by at least a first jointconfigured to allow adjustment of the second along the first axis; (v)wherein the first arm support and the second arm support are configuredto be independently adjustable, such that the first arm support can bemoved to a first height and the second arm support can be independentlymoved to a second height different than the first height; (x) whereinthe first arm support is configured to be stored below the table; and/or(y) wherein the base comprises one or more wheels configured such thatthe system is mobile.

In another aspect, a system can include a table configured to support apatient. The system can include a column extending along a first axisbetween a first end and a second end. The first end can be coupled tothe table. A base can be coupled to the second end of the column. Thesystem can include a first arm support comprising a first bar having aproximal portion and a distal portion extending along a second axis, thefirst bar coupled to at least one of the table, column or base by atleast a first joint configured to allow adjustment of the first baralong the first axis, the first arm support configured to support atleast one robotic arm. The system can also include a second arm supportcomprising a second bar having a proximal portion and a distal portionextending along a third axis coupled to the column by at least a secondjoint configured to allow adjustment of the second bar along the firstaxis, the second arm support configured to support at least anotherrobotic arm. In some embodiments, the first arm support and the secondarm support are configured such that the position of the first bar andthe second bar along the first axis can be adjusted independently.

The system can include one or more of the following features in anycombination: (a) wherein the first axis is a vertical axis, the firstjoint is configured to allow adjustment of the first bar in a verticaldirection, the second joint is configured to allow adjustment of thesecond bar in the vertical direction, and wherein the first bar and thesecond bar can be adjusted to different heights; (b) wherein the firstarm support is configured to be positioned on a first side of the table,and the second arm support is configured to be positioned on a secondside of the table; (c) wherein the second side is opposite the firstside; (d) wherein: the first arm support comprises a third jointconfigured to adjust a tilt angle of the second axis of the first barrelative to the surface of the table, and the second arm supportcomprises a fourth joint configured to adjust a tilt angle of the thirdaxis of the second bar relative to the surface of the table; (e) whereinthe tilt angle of the first bar axis and the tilt angle of the secondbar axis can be adjusted independently; (f) wherein the first armsupport further comprises a first bar connector that is pivotallycoupled to the column by at least a fifth joint, and the second armsupport further comprises a second bar connector that is pivotallycoupled to the column by at least a sixth joint; (g) wherein the firstbar connector and the second bar connector can be pivoted independently;(h) wherein the first further comprises a seventh joint configured toallow translation of the first bar relative to the column along thesecond axis, and the second arm support further comprises an eighthjoint configured to allow translation of the second bar relative to thecolumn along the third axis; (i) wherein the translation of the firstbar along the first bar axis and the translation of the second bar alongthe second bar axis can be adjusted independently; (j) wherein the firstand second arm supports are configured to be stored below the table; (k)wherein one or more of the first joint and the second joint aremotorized or controlled by hydraulics; (l) wherein the first armsupports at least two robotic arms that are linearly translatablerelative to one another; and/or (m) multiple robotic arms on the firstarm support and multiple robotic arms on the second arm support, whereinthe number of arms on the first arm support is equal to the number ofarms on the second arm support.

In another aspect, an arm support is disclosed. The arm support caninclude a bar extending along a first axis. The bar can be configured tosupport at least one robotic arm such that the at least one robotic armcan translate along the first axis. The bar can be configured to coupleto a column supporting a table. The arm support can include a firstjoint configured to facilitate adjusting a vertical position of the baralong a second axis of the column, a second joint configured tofacilitate adjusting a tilt angle of the first axis relative to asurface of the table, a bar connector configured to pivotally couple tothe column by at least a third joint, and a fourth joint configured tofacilitate translation of the bar along the first axis.

The arm support can include one or more of the following features in anycombination: (a) wherein one or more of the first joint, second joint,third joint and fourth joint are motorized or controlled by hydraulics;(b) wherein the second axis is a vertical axis and the first joint isconfigured to allow adjustment of the bar in a vertical direction; (c)wherein the first joint comprises a linear joint configured to movealong the second axis; (d) wherein the second joint comprises arotational joint configured to rotate around a third axis that isdifferent than the second axis; (e) wherein the third joint comprises arotational joint configured to pivot the bar connector about a fourthaxis that is different than the first axis; (f) wherein the third jointis configured to pivot the bar connector to adjust a positioning of thebar relative to the column; (g) wherein the third joint is positioned ata first end of the bar connector, the first end of the bar connectorconfigured to couple to the column, and wherein an additional joint ispositioned at a second end of the bar connector, the second end of thebar connector coupled to the bar, and wherein the additional joint ismechanically constrained to the third joint such that the additionaljoint and the third joint rotate together; (h) wherein the additionaljoint is mechanically constrained to the third motorized joint via afour-bar linkage; (i) wherein the additional joint is mechanicallyconstrained to the third motorized joint such that an orientation of thebar does not change as the bar connector pivots; and/or (j) wherein thefourth joint comprises a linear joint.

In another aspect, disclosed is a system that can include a tableconfigured to support a patient positioned on a surface of the table.The system can include a column extending along a first axis between afirst end and a second end. The first end can be coupled to the table. Abase can be coupled to the second end of the column. The system caninclude an arm support comprising a bar extending along a second axis.The bar can be coupled to at least one of the table, column, or base bya first joint configured to allow adjustment of the bar along the firstaxis. The arm support can be configured to support at least one roboticarm. The system can also include at least one computer-readable memoryhaving stored thereon executable instructions, and at least oneprocessor in communication with the at least one computer-readablememory and configured to execute the instructions to cause the system toat least adjust a position of the bar along the first axis in responseto receiving a command.

The system can include one or more of the following features in anycombination: (a) wherein the command comprises a command to adjust aposition of a robotic medical tool coupled to a robotic arm coupled tothe arm support; (b) wherein the at least one processor is furtherconfigured to execute the instructions to cause the system to at leastadjust a position of the bar in response to a clinician selectedprocedure; (c) wherein the at least one processor is further configuredto execute the instructions to cause the system to at least adjust aposition of the bar to avoid a collision between the robotic arm and atleast one of: the table, a patient, an additional robotic arm, and amedical imaging device; and/or (d) one or more of: a second jointconfigured to allow the bar to tilt to adjust an angle of the bar axisrelative to a surface of the table, a bar connector configured topivotally couple to the column by at least a third joint, a fourth jointconfigured to allow translation of the bar relative to the column alongthe bar axis, and wherein the least one processor is further configuredto execute the instructions to cause the system to at least control atleast one of the second joint, the third joint, and the fourth joint toadjust the position of the bar.

In another aspect, disclosed is a method that can include providing atable configured to support a patient positioned on a surface of thetable; providing a column extending along a first axis between a firstend and a second end, the first end coupled to the table; providing abase coupled to the second end of the column; providing an arm supportcomprising a bar extending along a bar axis coupled to at least one ofthe table, column or base by at least a first joint configured to allowadjustment of the bar along the first axis, the arm support configuredto support at least one robotic arm; and actuating the first joint toadjust a position of the bar along the first axis.

The method can include one or more of the following features in anycombination: (a) providing a first robotic arm mounted to the first bar;and translating the first robotic arm the second axis; (b) providing asecond robotic arm mounted to the first bar, and translating the secondrobotic arm the second axis; (c) wherein the second robotic arm isconfigured to translate along the second axis independently of the firstrobotic arm; (d) providing a third robotic arm mounted to the first bar;(e) wherein at least one of the first robotic arm, second robotic arm orthird robotic arm holds a camera; (f) wherein at least one of the firstrobotic arm, the second robotic arm, or the third robotic arm can bestowed under the table; (g) wherein the first arm support comprises asecond joint configured to adjust a tilt angle of the first bar, andwherein the method further comprises adjusting the tilt angle of the barby actuating the second joint; (h) wherein the second joint comprises amotorized rotational joint configured to rotate around a third axis thatis different than the first axis; (i) wherein the first arm supportcomprises a third joint and a bar connector, the bar connectormechanically coupling the first bar with the third joint; (j) actuatingthe third joint to pivot the bar connector to adjust a positioning ofthe first bar relative to the column; (k) wherein the first bar iscapable of translation along a length of the table such that the firstbar can extend beyond an end of the table; (l) wherein the first bar isfurther coupled to the column by at least one fourth joint configured toallow translation of the first bar relative to the column along thesecond axis, and wherein the method further comprise translating thefirst bar relative to the column along the second axis; (m) providing asecond arm support coupled to at least one of the table, column or baseand configured to be positioned on a second side of the table; and/or(n) moving the first arm support to a first height, and moving thesecond arm support to a second height different than the first height.

In another aspect, disclosed is a method that includes: receiving acommand regarding positioning of at least one of: a first robotic arm; amedical instrument coupled to an end effector of the robotic first arm;and an arm support coupled to a base of the first robotic arm and to acolumn supporting a patient-support table, wherein the arm supportcomprises at least one joint and a bar configured to support the firstrobotic arm; and actuating, based on the received command, the at leastone joint to adjust a position of the arm support along a vertical axisof the column.

The method may include one or more of the following features in anycombination: (a) wherein a first command actuates the at least one jointto adjust the position of the arm support along a vertical axis of thecolumn, a second command actuates a second joint for pivoting up the armsupport, a third command actuates a third joint for tilting the armsupport and a fourth command causes longitudinal translation of the armsupport; (b) wherein a second robotic arm is coupled to the bar of thearm support; (c) raising the arm support, the first robotic arm, and thesecond robotic arm from a stowed position below the table; positioningthe arm support, the first robotic arm and the second robotic armadjacent the table; adjusting a position of the arm support relative tothe table via at least one of the first command, second command, thirdcommand, or fourth command; and adjusting a position of the firstrobotic arm relative to the second robotic arm along the bar of thesupport joint in preparation for a surgical procedure; (d) wherein thearm support is positioned below an upper surface of the table; and/or(e) a controller for executing one or more commands based on akinematics model, wherein the one or more commands control thepositioning of one or more of the first robotic arm; the medicalinstrument coupled to an end effector of the robotic first arm; and anarm support coupled to a base of the first robotic arm and to a columnsupporting a patient-support table, wherein the arm support comprises atleast one joint and a bar configured to support the first robotic arm.

In another aspect, disclose is a system that can include a tableconfigured to support a patient positioned on a surface of the table,one or more supports for the table, and an arm support for holding oneor more arms adjustable relative to the table, wherein a height of thearm support is adjustable relative to the table.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an isometric view of a surgical robotics system according toan embodiment.

FIG. 2A is an isometric view of a table of the surgical robotics systemaccording to one embodiment.

FIG. 2B is a top view of the table according to one embodiment.

FIG. 2C is a top view of a swivel segment of a table according to oneembodiment.

FIG. 2D is a top view of a swivel segment of the table according to oneembodiment.

FIG. 2E is an isometric exploded view of components of a swivelmechanism according to one embodiment.

FIG. 2F is a cross sectional view of the swivel mechanism shown in FIG.2E according to one embodiment.

FIG. 2G is a bottom view of the swivel mechanism shown in FIG. 2Eaccording to one embodiment.

FIG. 2H is an isometric view of a folding segment of the table accordingto one embodiment.

FIG. 2I is another isometric view of a folding segment of the tableaccording to one embodiment.

FIG. 2J is an isometric view of a trapdoor of the table according to oneembodiment.

FIG. 2K is an isometric view of pivots of the table according to oneembodiment.

FIG. 2L is a side view of the table rotated about an axis of pitchaccording to one embodiment.

FIG. 2M is an isometric view of the table rotated about an axis of rowaccording to one embodiment.

FIG. 3A is a side cutaway view of a column of the surgical roboticssystem according to one embodiment.

FIG. 3B is an isometric cutaway view of the column according to oneembodiment.

FIG. 3C is a top view of the column according to one embodiment.

FIG. 4A is an isometric view of a surgical robotics system with acolumn-mounted robotic arm according to one embodiment.

FIG. 4B is an isometric view of a surgical robotics system withcolumn-mounted robotic arms according to one embodiment.

FIG. 5A is an isometric view of a column ring of the surgical roboticssystem according to one embodiment.

FIG. 5B is a bottom view of a set of column rings underneath a tableaccording to one embodiment.

FIG. 5C is an isometric view of the set of column rings mounted to acolumn according to one embodiment.

FIG. 5D is an isometric cutaway view of an arm mount of a column ringaccording to one embodiment.

FIG. 5E is an isometric cutaway view of the arm mount in a telescopedconfiguration according to one embodiment.

FIG. 6A is an isometric view of a robotic arm of the surgical roboticssystem according to one embodiment.

FIG. 6B is an isometric view of an arm segment joint of the robotic armaccording to one embodiment.

FIG. 6C is an isometric view of another arm segment joint of the roboticarm according to one embodiment.

FIG. 7A is an isometric view of a surgical robotics system withcolumn-mounted arms configured to access the lower body area of apatient according to one embodiment.

FIG. 7B is a top view of the surgical robotics system withcolumn-mounted arms configured to access the lower body area of thepatient according to one embodiment.

FIG. 7C is an isometric view of an imaging device and a surgicalrobotics system with column-mounted arms configured to access the lowerbody area of a patient according to one embodiment.

FIG. 7D is a top view of the imaging device and the surgical roboticssystem with column-mounted arms configured to access the lower body areaof the patient according to one embodiment.

FIG. 7E is an isometric view of the surgical robotics system withcolumn-mounted arms configured to access the core body area of a patientaccording to one embodiment.

FIG. 7F is an isometric view of the surgical robotics system withcolumn-mounted arms configured to access the upper body area of apatient according to one embodiment.

FIG. 8A is an isometric view of a base of a surgical robotics systemaccording to one embodiment.

FIG. 8B is an isometric view of open panels of the base according to oneembodiment.

FIG. 8C is an isometric view of robotic arms stowed inside a base of asurgical robotics system according to one embodiment.

FIG. 8D is an isometric view of robotic arms stowed underneath a tableof a surgical robotics system according to one embodiment.

FIG. 8E is an isometric view of robotic arms stowed above a base of asurgical robotics system according to one embodiment.

FIG. 8F is another isometric view of robotic arms stowed above a base ofa surgical robotics system according to one embodiment.

FIG. 8G is an isometric view of outrigger casters on a base of asurgical robotics system according to one embodiment.

FIG. 8H is another isometric view of the outrigger casters on the baseof the surgical robotics system according to one embodiment.

FIG. 8I is a side view of an outrigger caster in a mobile configurationaccording to one embodiment.

FIG. 8J is a side view of the outrigger caster in a stationaryconfiguration according to one embodiment.

FIG. 9A is an isometric view of a surgical robotics system with arail-mounted robotic arm according to one embodiment.

FIG. 9B is an isometric view of a surgical robotics system withrail-mounted robotic arms according to one embodiment.

FIG. 10A is an isometric view of base rails of a surgical roboticssystem according to one embodiment.

FIG. 10B is an isometric view of arm mounts on the base rail accordingto one embodiment.

FIG. 10C is an isometric cutaway view of an arm mount on the base railaccording to one embodiment.

FIG. 10D is cross sectional views of the base rail according to oneembodiment.

FIG. 11 is an isometric view of a surgical robotics system withcolumn-mounted robotics arms and rail-mounted robotic arms according toone embodiment.

FIG. 12 is an isometric view of a surgical robotics system withcolumn-mounted robotics arms on a platform separate from a table and abase of the surgical robotics system according to one embodiment.

FIG. 13A is an isometric view of a surgical robotics system with anadjustable arm support according to one embodiment.

FIG. 13B is an end view of the surgical robotics system with anadjustable arm support of FIG. 13A.

FIG. 14A is an end view of a surgical robotics system with twoadjustable arm supports mounted on opposite sides of a table accordingto one embodiment.

FIG. 14B is an isometric view of a surgical robotics system with twoadjustable arm supports and a plurality of robotic arms configured for alaparoscopic procedure according to one embodiment.

FIG. 14C is an isometric view of a surgical robotics system with twoadjustable arm supports and a plurality of robotic arms configured for alaparoscopic procedure according to one embodiment.

FIG. 15A is an isometric view of a surgical robotics systems with twoadjustable arm supports that are configured to translate to adjust theposition of the adjustable arm supports according to one embodiment.

FIG. 15B is an isometric view of a surgical robotics system with anadjustable arm support and robotic arm configured for an endoscopicprocedure according to one embodiment.

FIG. 16 is an isometric view of a surgical robotics system with anadjustable arm support configured with a rail capable of tiltingaccording to one embodiment.

FIG. 17A is an isometric view of a surgical robotics system withadjustable arm supports positioned to allow access for a C-arm of amedical imaging device according to one embodiment.

FIG. 17B is an isometric view of the surgical robotics system of FIG.17A with the adjustable arm supports positioned to allow access for theC-arm of the medical imaging device according to another embodiment.

FIG. 18A is an isometric view of a surgical robotics system withadjustable arm supports positioned in a deployed configuration accordingto one embodiment.

FIG. 18B is an isometric view of a surgical robotics system withadjustable arm supports positioned in a stowed configuration accordingto one embodiment.

FIG. 19 is a flow chart illustrating a method for operating a surgicalrobotics system with adjustable arm supports according to oneembodiment.

FIG. 20 is a block diagram of a surgical robotics system with adjustablearm supports according to one embodiment.

FIG. 21 is an isometric view of a robotic arm according to oneembodiment.

Reference will now be made in detail to several embodiments, examples ofwhich are illustrated in the accompanying figures. It is noted thatwherever practicable similar or like reference numbers may be used inthe figures and may indicate similar or like functionality. The figuresdepict embodiments of the described system (or method) for purposes ofillustration only. One skilled in the art will readily recognize fromthe following description that alternative embodiments of the structuresand methods illustrated herein may be employed without departing fromthe principles described herein.

DETAILED DESCRIPTION I. System Overview

FIG. 1 is an isometric view of a surgical robotics system 100 accordingto an embodiment. A user, e.g., a physician or assistant, uses thesurgical robotics system 100 to perform robotically-assisted surgery ona patient. The surgical robotics system 100 includes a table 101, column102, and base 103 physically coupled together. Although not shown inFIG. 1, the table 101, column 102, and/or base 103 may house, connectto, or use electronics, fluidics, pneumatics, aspiration, or otherelectrical and mechanical components that support the function of thesurgical robotics system 100.

The table 101 provides support for a patient undergoing surgery usingthe surgical robotics system 100. Generally, the table 101 is parallelto the ground, though the table 101 may change its orientation andconfiguration to facilitate a variety of surgical procedures. The table101 is further described with reference to FIGS. 2A-I in Section II.Table.

The column 102 is coupled to the table 101 on one end and coupled to thebase 103 on the other end. Generally, the column 102 is cylindricallyshaped to accommodate column rings coupled to the column 102, which arefurther described with reference to FIGS. 5A-E in Section V. ColumnRing, however the column 102 may have other shapes such as oval orrectangular. The column 102 is further described with reference to FIGS.3A-B in Section III. Column.

The base 103 is parallel to the ground and provides support for thecolumn 102 and the table 101. The base 103 may include wheels, treads,or other means of positioning or transporting the surgical roboticssystem 100. The base 103 is further described with reference to FIGS.8A-E in Section VIII. Base.

Alternative views and embodiments of the surgical robotics system 100including the above mentioned components are further illustrated anddescribed at least in U.S. Provisional Application No. 62/162,486 filedMay 15, 2015 and U.S. Provisional Application No. 62/162,467 filed May15, 2015.

II. Table

FIG. 2A is an isometric view of a table 201A of the surgical roboticssystem 100 according to one embodiment. The table 201A is an embodimentof the table 101 in FIG. 1. The table 201A includes a set of one or moresegments. Generally, a user changes the configuration of the table 201Aby configuring the set of segments. The surgical robotics system 100 mayalso configure the segments automatically, for example, by using a motorto reposition a segment of the set of segments. An example set ofsegments is shown in FIG. 2A, and includes a swivel segment 210, centersegment 212, foldable segment 214, detachable segment 216, and tablebase 218. The swivel segment 210, center segment 212, and foldablesegment 214 are coupled to the table base 218. FIG. 2A shows thedetachable segment 216 separated from the table base 218, though thedetachable segment 216 may also be coupled to the table base 218. Invarious implementations, additional or fewer segments may be used.

An advantage of configuring the set of segments of the table 201A isthat a configured table 201A may provide greater access to a patient onthe table 201A. For instance, the surgical robotics system 100 performsa surgical procedure on the patient that requires access to the groinarea of the patient. When a patient is laying face-up on a typicalsurgical bed, there is more access to the patient's head, arms, and legsthan to the patient's groin area. Since the groin area is located towardthe center of the patient's body, the legs often obstruct access to thegroin area. The detachable segment 216 is detachable from the table201A. The table 201A without the detachable segment 216 provides greateraccess to the groin area of a patient lying on the table 201A with thepatient's head toward the side of the table 201A with the swivel segment210. In particular, removing the detachable segment 216 opens morespace, for example, to insert a surgical instrument into the groin area.If additional space is required to access the groin area, the foldablesegment 214 may be folded down, away from the patient (further describedin FIG. 2H). The center segment 212 includes a cutout section 220, whichalso provides greater access to the groin area.

The swivel segment 210 pivots laterally relative to the table 201A. Theswivel segment 210 includes an arcuate edge 222 and the center segment212 also includes in arcuate edge 224. Due to the arcuate edges, thereis minimal gap between the swivel segment 210 and the center segment 212as the swivel segment 210 pivots away from or toward the table 201A. Aconfiguration of the table 201A with the swivel segment 210 pivoted awayfrom the table 201A provides greater access to the groin area becausethe other segments of the table 201A are not obstructing the groin area.An example of this configuration is further described with respect toFIGS. 7C-D in Section VII. A. Lower Body Surgery. Additionally, theswivel segment 210 also includes a cutout section 226, which providesyet greater access to the groin area.

FIG. 2B is a top view of the table 201A according to one embodiment.Specifically, FIG. 2B shows the table base 218 with a partial cutawayview and a portion of the swivel segment 210. Components inside theswivel segment 210 are exposed for purposes of illustration. The tablebase 218 includes double curved rails 230, that is, two curved linearrails (also referred to as a first bearing subassembly). The swivelsegment 210 also includes double curved rails 232 (also referred to as asecond bearing subassembly). The first bearing assembly coupled to thesecond bearing assembly may be referred to as a bearing mechanism. Thedouble curved rails 230 of the table base 218 engage with the doublecurved rails 232 of the swivel segment 210. Both double curved rails areconcentric to a virtual circle 234. The swivel segment 210 pivots aboutan axis passing through a point 236 at the center of the virtual circle234 perpendicular to the plane of the table base 218. The double curvedrails 230 of the table base 218 include a first carriage 238 and asecond carriage 240. Similarly, the double curved rails 232 of theswivel segment 210 include a first carriage 242 and a second carriage244. The carriages provide structural support and negate moment loads,which enables the double curved rails to support high cantilevered loadsup to at least 500 pounds. For instance, pivoting a patient away fromthe table 201A generates a high cantilevered load on the double curvedrails supporting the patient's weight. The table base 218 and swivelsegment 210 may include additional load-sharing components such asrollers, cam followers, and bearings. In some embodiments, the swivelsegment 210 and table base 218 each include a single curved rail insteadof double curved rails. Further, each curved rail may include additionalor fewer carriages.

FIG. 2C is a top view of the swivel segment 210 of the table 201Aaccording to one embodiment. The center of mass 250 illustrates thecenter of mass of the swivel segment 210 and a patient (not shown) lyingon the swivel segment 210. The swivel segment 210 is pivoted at an angleα about the axis 236. Compared to the center of mass 246 shown in FIG.2D, the center of mass 250 is closer toward the table base 218(corresponding to table base 218B in FIG. 2D), even though the swivelsegments in both FIG. 2C and FIG. 2D are each pivoted at the same angleα. Keeping the center of mass 250 close toward the table 218 helps theswivel segment 210 support greater cantilever loads—due to thepatient—without tipping over the surgical robotics system. In someembodiments, the swivel segment 210 may be rotated up to an angle of 30degrees or 45 degrees relative to table base 218, while keeping thecenter of mass of the swivel segment 210 above the table 201A.

FIG. 2D is a top view of a swivel segment 210A of a table 201B accordingto one embodiment. Specifically, the table 201B includes a table base218A and a swivel segment 210A. The table 201B does not include doublecurved rails, but instead includes a swivel mechanism 278 that isfurther described below with reference to FIGS. 2E-G. The center of mass246 illustrates the center of mass of the swivel segment 210A and apatient (not shown) lying on the swivel segment 210A. The swivel segment210A is pivoted at an angle α about an axis 248. Accordingly, the centerof mass 246 is positioned off of the table base 218A.

FIG. 2E is an isometric exploded view of components of a swivelmechanism 278 (which can also be referred to as a bearing mechanism) ofthe table 201B according to one embodiment. The swivel mechanism 278includes a first bearing subassembly coupled to a second bearingsubassembly. In particular, the swivel mechanism 278 includes a harmonicdrive motor 280, static plate 281, shim 282, inner bearing race 283,bearing 284, outer bearing race cleat 285, inner bearing race support286, static ring 287, motor housing mount 288, encoder strip 289, driveplate 290, encoder sensor 291, and swivel insert 292. The motor housingmount 288 is stationary relative to the table base 218A. The harmonicdrive motor 280 rotates the swivel segment 210A about the axis 248. Thefirst bearing subassembly includes the components described above thatare coupled to the table base 218A. The second bearing subassemblyincludes the components described above that are coupled to the swivelsegment 210A.

FIG. 2F is a cross sectional view of the swivel mechanism 278 shown inFIG. 2E according to one embodiment. The harmonic drive motor 280 iscoupled to the motor housing mount 288. The motor housing mount 288 iscoupled to the static ring 287 and the static plate 281. The staticplate 281 is coupled to the table base 218A using the shim 282 such thatthe harmonic drive motor 280 is also stationary relative to the tablebase 218A.

The harmonic drive motor 280 includes a driving axle 294 coupled to adriving face 296 such that the driving axle 294 and driving face 296rotate together. The driving face 296 is coupled to the drive plate 290.The drive plate 290 is coupled to the inner bearing race support 286.The inner bearing race support 286 is coupled to the swivel insert 292and the inner bearing race cleat 283. The inner bearing race support 286is movably coupled to the table base 218A by the bearing 284 (e.g., across roller bearing). The swivel insert 292 is coupled to the swivelsegment 210A such that rotating the driving axle 294 and driving face296 causes the swivel segment 210A to rotate in the same direction.Though not shown in FIG. 2F, the swivel mechanism 278 may includeadditional components between the static plate 281 and the inner bearingrace cleat 283 to provide additional stability, e.g., in the form of aphysical hard stop. Further, though not shown in FIG. 2F, the encodersensor 291 is coupled to the motor housing mount 288 by the encoderstrip 289. The encoder sensor 291 records information about the rotationof the swivel segment 210A, e.g., the position of the swivel segment210A up to an accuracy of 0.1 degrees at 0.01 degree resolution. FIG. 2Fshows several screws (or bolts) that are used to couple components ofthe swivel mechanism, though it should be noted that the components maybe coupled using other methods, e.g., welding, press fit, gluing, etc.

The swivel mechanism 278 allows the harmonic drive motor 280 to rotatethe swivel segment 210A with precise control, while supporting a load ofup to 500 pounds, e.g., from a patient lying on the swivel segment 210A.In particular, the harmonic drive motor 280 may rotate the swivelsegment 210A up to a rotational velocity of 10 degrees per second, andup to 45 degrees in either direction about the axis 248. Further, theswivel segment 210A is rotated such that the maximum velocity of thecenter of mass of the patient is 100 millimeters per second, and thetime to the maximum velocity is 0.5 seconds. In some embodiments, one ofthe bearings of the swivel mechanism is a cross roller bearing—e.g.,with ball bearings with a bearing friction coefficient of approximately0.0025—that helps further provide stability to allow the preciserotation of the swivel segment 210A, while maintaining cantilever loadsfrom the patient's weight. The harmonic drive motor 280 can generate upto 33 Newton meters of torque to rotate the swivel segment 210A with theweight of the patient. In some embodiments, the harmonic drive motor 280includes an internal brake with a holding torque of at least 40 Newtonmeters.

FIG. 2G is a bottom view of the swivel mechanism shown in FIG. 2Eaccording to one embodiment. The harmonic drive motor 280 is exposedsuch that electrical wires, e.g., from a column of the surgical roboticssystem, may be coupled to the harmonic drive motor 280 to providecontrol signals to the harmonic drive motor 280.

FIG. 2H is an isometric view of a foldable segment 214C of a table 201Caccording to one embodiment. The table 201C is an embodiment of table201A in FIG. 2A. The table 201C also includes a center segment 212Ccoupled to a table base 218C. The foldable segment 214C rotates usingbearings about an axis 252 parallel to the table base 218C. The foldablesegment 214C is rotated such that the foldable segment 214C isorthogonal to the table base 218C and the center segment 212C. In otherembodiments, the foldable segment 214C may be rotated to other anglesrelative to the table base 218C and the center segment 212C. Thefoldable segment 214C includes a cutout section 254, for example, toprovide greater access to a patient lying on the table 201C. In otherembodiments, the foldable segment 214C does not include a cutoutsection.

FIG. 2I is another isometric view of a foldable segment 214D of a table201D according to one embodiment. The table 201D is an embodiment oftable 201A in FIG. 2A. The foldable segment 214D is rotated such thatthe foldable segment 214D and the table base 218D is positioned at anangle β relative to each other. The table 201D includes a mechanism forthe foldable segment 214D and the center segment 212D to maintain therotated position while supporting the weight of a patient on the table201D. For example, the mechanism is a friction brake at the joint of thefoldable segment 214D and the center segment 212D that holds the twosegments at the angle β. Alternatively, the foldable segment 214Drotates about the center segment 212D using a shaft and the mechanism isa clutch that locks the shaft, and thus keeps the two segments at afixed position. Though not shown in FIG. 2I, the table 201D may includemotors or other actuators to automatically rotate and lock the foldablesegment 214D to a certain angle relative to the center segment 212D.Rotating the foldable segment 214D is advantageous, for example, becausethe corresponding configuration of the table 201D provides greateraccess to the area around the abdomen of a patient lying on the table201D.

FIG. 2J is an isometric view of a trapdoor 256 of a table 201E accordingto one embodiment. The table 201E is an embodiment of table 201A in FIG.2A. Specifically, the table 201E includes the trapdoor 256 and adrainage component 258 positioned below the trapdoor 256. The trapdoor256 and drainage component 258 collect waste materials such as fluid(e.g., urine), debris (e.g., feces) that are secreted or released by apatient lying on the table during a surgical procedure. A container (notshown) may be positioned below the drainage component 258 to collect andstore the waste materials. The trapdoor 256 and drainage component 258are advantageous because they prevent waste materials from soiling orde-sterilizing equipment such as other components of the surgicalrobotic system 100 or other surgical tools in an operating room with thesurgical robotic system 100.

FIG. 2K is an isometric view of pivots of the table 201A according toone embodiment. Specifically, the table 201A includes a first pivot 260and a second pivot 262. The table 201A rotates about a first axis 264. Auser, e.g., a physician, may rotate the table 201A about the first axis264 or the second axis 266 manually or assisted by the surgical roboticssystem 100. The surgical robotics system 100 may also rotate the table201A automatically, for example, by using control signals to operate amotor coupled to the first pivot 260 or the second pivot 262. The motor280 is coupled to the first pivot 260. Rotation of the table 201A mayprovide greater access to certain areas of a patient lying on the table201A during a surgical procedure. Specifically, the table 201A isconfigured to orient a patient lying on the table 201A in aTrendelenburg position by rotating about the first axis 264. Rotation ofthe table 201A is further described in FIGS. 2L-M.

FIG. 2L is a side view of the table 201A rotated about the axis of pitch264 according to one embodiment. Specifically, the table 201A is rotatedto an angle γ relative to a plane 268 parallel to the ground.

FIG. 2M is an isometric view of the table 201A rotated about the axis ofrow 266 according to one embodiment. Specifically, the table 201A isrotated to an angle δ relative to the plane 268 parallel to the ground.The table 201A is illustrated as transparent to expose componentsunderneath the table 201A. The table includes a set of rails 270. Thetable 201A may translate laterally along an axis 266 parallel to the setof rails 270. The surgical robotics system 100 translates the table 201Alaterally using, for example, a motor or other means of actuation (notshown). A user of the surgical robotics system 100 may also manuallytranslate the table 201A, or with assistance from the surgical roboticssystem 100.

Alternative views and embodiments of the table 201A including the abovementioned components are further illustrated and described at least inU.S. Provisional Application No. 62/235,394 filed Sep. 30, 2015.

III. Column

FIG. 3A is a side cutaway view of the column 102 of the surgicalrobotics system 100 according to one embodiment. The column 102 includeselectrical and mechanical and other types of components to performfunctions of the surgical robotics system 100. The column 102 includes apitch rotation mechanism 310, column telescoping mechanism 320, ringtelescoping mechanisms 330A and 330B, and ring rotation mechanisms 340Aand 340B. The ring rotation mechanisms 340A and 340B are furtherdescribed in FIG. 3B.

The surgical robotics system 100 rotates the table 101 about the axis ofpitch 264 (also illustrated previously in FIGS. 2K-L) using the pitchrotation mechanism 310. The pitch rotation mechanism 310 includes apitch rotation motor 312, right angle gearbox 314, pitch rotation leadscrew 316, and pitch rotation bracket 318. The pitch rotation motor 312is coupled to the right angle gearbox 314. The pitch rotation motor 312is orthogonal to the pitch rotation lead screw 316. The pitch rotationlead screw 316 is movably coupled to the pitch rotation bracket 318. Theright angle gearbox 314 is coupled to the pitch rotation lead screw 316.Output rotation of the pitch rotation motor 312 causes translationalmotion of the pitch rotation lead screw along an axis 311. Accordingly,translational motion of the pitch rotation lead screw 318 causes thetable 101 to rotate about the axis of pitch 264.

The surgical robotics system 100 translates the table vertically usingthe column telescoping mechanism 320. The column telescoping mechanism320 includes a column telescoping motor 322, column telescoping leadscrew 324, and column telescoping rail 326. The column telescoping motor322 is coupled to the column telescoping lead screw 324. The columntelescoping motor 322 and the column telescoping lead screw 324 arestationary relative to the base 103. The column telescoping lead screw324 is engaged with the column telescoping rail 326. Output rotation ofthe column telescoping motor 322 causes the column telescoping rail 326to translate along a vertical axis 321 along the column telescoping leadscrew 324. As the column telescoping rail 326 translates in the positivedirection along the vertical axis 321, the height of the column 102 andthe table 101 increases.

The column 102 also includes a lower column segment 350, middle columnsegment 352, and upper column segment 354. The lower column segment 350is coupled to the base 103 and stationary relative to the base 103. Themiddle column segment 352 is movably coupled to the lower column segment350. The upper column segment 354 is movably coupled to the middlecolumn segment 352. In other embodiments, a column 102 may includeadditional or fewer column segments.

The upper column segment 354 and/or the middle column segment 352 alsotranslate along the vertical axis 321 to extend the height of the column102. Similarly, as the column telescoping rail 326 translates in thenegative direction along the vertical axis 321, the height of the column102 and the table 101 decreases. Further, the upper column segment 354and/or the middle column segment 352 also translate along the verticalaxis 321, collapsing over the lower column segment 350. A table 101 withadjustable height is advantageous because the table 101 facilitates avariety of surgical procedures. Specifically, one surgical procedurerequires a patient lying on the table 101 to be positioned at a heightlower than the height of a patient lying on the table 101 for adifferent surgical procedure. In some embodiments, the columntelescoping mechanism 320 uses other means of actuation such ashydraulics or pneumatics instead of—or in addition to—motors.

The surgical robotics system 100 translates column rings 305A and 305Bvertically using the ring telescoping mechanisms 330A and 330B. The ringtelescoping mechanism 330A includes a ring telescoping motor 332, ringtelescoping lead screw 334, and ring telescoping rail 336. Column ringsare further described with reference to FIGS. 5A-E in Section V. ColumnRing. Column rings 305A and 305B are movably coupled to the column 102and translate along a vertical axis 331. Generally, a column 102includes a ring telescoping mechanism for each column ring of the column102. Specifically, the column 102 includes ring telescoping mechanism330A and second ring telescoping mechanism 330B. The ring telescopingmotor 332 is coupled to the ring telescoping lead screw 334. The ringtelescoping motor 332 and the ring telescoping lead screw 334 arestationary relative to the base 103. The ring telescoping lead screw 334is engaged with the ring telescoping rail 336. The ring telescoping rail336 is coupled to the column ring 305A. Output rotation of the ringtelescoping motor 332 causes the ring telescoping rail 336 to translatealong the vertical axis 331 and along the ring telescoping lead screw334. As the ring telescoping rail 336 translates in the positivedirection or negative direction along the vertical axis 331, the heightof a corresponding column ring increases or decreases, respectively.

FIG. 3B is an isometric cutaway view of the column 102 according to oneembodiment. The column 102 includes a first accordion panel 360A and asecond accordion panel 360B. The accordion panels 360A and 360B extendor fold as the surgical robotics system 100 translates column rings 305Aand 305B in the positive direction or negative direction along thevertical axis 331, respectively. The accordion panels 360A and 360B areadvantageous because they protect electrical and mechanical and othertypes of components inside the column 102 (e.g., the pitch rotationmechanism 310, column telescoping mechanism 320, ring telescopingmechanisms 330A and 330B, and ring rotation mechanisms 340A and 340B)from becoming soiled or de-sterilized by fluid waste and other hazards.FIG. 3B shows an isometric view of the ring rotation mechanism 340A,while the ring rotation mechanism 340B is obscured by the column 102.

The surgical robotics system 100 rotates column rings 305A and 305Busing the ring rotation mechanisms 340A and 340B, respectively. The ringtelescoping rail 336 is coupled to the ring rotation motor 342 by a ringrotation bracket 344. The ring rotation motor 342 is coupled to a set ofgears 346. The set of gears 346 includes a driving gear 346G. Thedriving gear 346G is engaged with a column ring rail 348 of the columnring 305A. Output rotation of the ring rotation motor 342 causes the setof gears 346 and the driving gear 346G to rotate. Accordingly, therotation of the driving gear 346G causes the column ring 305A to rotateabout a vertical axis 341 concentric to the column 102. The column 102includes another ring rotation mechanism 340B corresponding to thecolumn ring 305B. Generally, both ring rotation mechanisms 340A and 340Band column rings 305A and 305B will be substantially the same, howeverin other implementations they may be constructed using differentmechanisms.

FIG. 3C is a top view of the ring rotation mechanism 340A according toone embodiment. For purposes of clarity, FIG. 3C only shows the drivinggear 346G, the column ring 305A, and the column ring rail 348 of thering rotation mechanism 340A. In an example use case, the surgicalrobotics system 100 rotates the driving gear 346G clockwise to rotatethe column ring rail 348—and thus, the column ring 305A—clockwise aboutthe vertical axis 341.

Alternative views and embodiments of the column 103 including the abovementioned components are further illustrated and described at least inU.S. Provisional Application No. 62/162,486 filed May 15, 2015 and U.S.Provisional Application No. 62/162,467 filed May 15, 2015.

IV. Column-Mounted Robotic Arms

FIG. 4A is an isometric view of a surgical robotics system 400A with acolumn-mounted robotic arm 470A according to one embodiment. Thesurgical robotics system 400A includes a set of robotic arms, a set ofcolumn rings, table 401A, column 402A, and base 403A. The surgicalrobotics system 400A is an embodiment of the surgical robotics system100 shown in FIG. 1. Generally, the set of robotics arms includes one ormore robotic arms, such as robotic arm 470A, where the robotic arms arecoupled to one or more column rings, such as column ring 405A. Columnrings are described in more detail with respect to FIGS. 5A-E in SectionV. Column Ring below. Robotic arms are described in more detail withrespect to FIGS. 6A-C in Section VI. Robotic Arm below. Column rings405A are movably coupled to the column 402A. Thus, a robotic arm 470Aattached to a column 405A may be referred to as a column-mounted roboticarm 470A. As introduced above, the surgical robotics system 400A usesrobotic arms 470A to perform surgical procedures on a patient lying onthe table 401A.

FIG. 4B is an isometric view of a surgical robotics system 400B withcolumn-mounted robotic arms according to one embodiment. The surgicalrobotics system 400B is an embodiment of the surgical robotics system400A shown in FIG. 4A. The surgical robotics system 400B includesmultiple robotic arms, i.e., a first robotic arm 470B, second roboticarm 470C, third robotic arm 470D, and fourth robotic arm 470E, as wellas multiple column rings, i.e., a first column ring 405B and secondcolumn ring 405C. In other embodiments, the surgical robotics system400B may include additional or fewer robotic arms and/or column rings.Further, the robotic arms may be coupled to column rings in variousconfigurations. For example, three robotic arms may be coupled to acolumn ring. Additionally, the surgical robotics system 400B may includethree column rings each coupled to two robotic arms.

Alternative views and embodiments of the surgical robotics system 400Bincluding the above mentioned components with column-mounted roboticarms are further illustrated and described at least in U.S. ProvisionalApplication No. 62/162,486 filed May 15, 2015 and U.S. ProvisionalApplication No. 62/162,467 filed May 15, 2015.

V. Column Ring

FIG. 5A is an isometric view of a column ring 505 of a surgical roboticssystem—for example, surgical robotics system 100, 400A, or400B—according to one embodiment.

The column ring 505 includes a column ring rail 510, arm mount pivot512, arm mount base 514, and a set of arm mounts. The set of arm mountsincludes one or more arm mounts. Specifically, the set of arm mounts inFIG. 5A includes a first arm mount 506A and a second arm mount 506B.Generally, each arm mount of the set of arm mounts and the arm mountbase 514 are cylindrically shaped.

The first arm mount 506A and the second arm mount 506B are movablycoupled the arm mount base 514. The first arm mount 506A and the secondarm 506B mount may rotate—together or independently—about the axis 511concentric to the arm mount base 514. For example, the surgical roboticssystem 400B rotates the first arm mount 506A and the second arm mount506B using a motor or other means of actuation (not shown) inside thearm mount base 514 or arm mounts. In some embodiments, the first armmount 506A and the second arm mount 506B rotate at predeterminedincrements, e.g., increments of 15 degrees.

The arm mount base 514 is coupled to the arm mount pivot 512. The armmount pivot 512 uses a motor or other means of actuation (not shown)inside the arm mount pivot 512 to rotate the arm mount base 514 aboutthe axis 521 orthogonal to the axis 511. The arm mount pivot 512 iscoupled to, and stationary relative to, the column ring rail 510.Rotating the arm mount base 514 is advantageous because robotic arms(and arm mounts) coupled to the arm mount base 514 may be reoriented inresponse to rotation of the table 401B. Accordingly, robotic armscoupled to the arm mounts of the arm mount base 514 have greater accessto a patient lying on the table 401B.

FIG. 5B is a bottom view of the set of column rings underneath the table401B of FIG. 4B according to one embodiment. The set of column ringsincludes the first column ring 405B and the second column ring 405C.Note that FIG. 5B shows the first column ring 405B and the second columnring 405C aligned such that the arm mounts are on the same side of thetable 401B, while FIG. 4B shows the first column ring 405B and thesecond column ring 405C positioned such that the arm mounts are onopposite sides of the table 401B. The surgical robotics system 400B mayrotate the column rings 405B and 405C to position the arm mounts inother configurations. For example, two arm mounts are positioned on oneside of the table 401B and two arm mounts are positioned on an oppositeside of the table 401B. By rotating column rings independently from eachother around the column, the surgical robotics system 400B may configurethe arm mounts—and thus, robotic arms mounted to the arm mounts—in agreater number of possible positions. Due to this configurability, thesurgical robotics system 400B accommodates a variety of surgicalprocedures because the robotic arms can access any area (e.g., upperbody, core body, or lower body) of the body of a patient lying on thetable 401B. In some embodiments, each arm mount of the column ringsinclude a notch 516 which facilitates the attachment of a robotic arm tothe arm mount.

FIG. 5C is an isometric view of the set of column rings mounted to thecolumn 402B of FIG. 4B according to one embodiment. Similarly to FIG.5B, FIG. 5C shows all the arm mounts aligned on the same side of thesurgical robotics system 400B.

FIG. 5D is an isometric cutaway view of an arm mount 506C of a columnring according to one embodiment. The arm mount 506C includes an armmount telescoping mechanism 520 and a set of arm mount segments. The armmount telescoping mechanism 520 includes an arm mount telescoping motor522, arm mount telescoping lead screw 524, and arm mount telescopingrail 526. Generally, the set of arm mount segments includes one or morearm mount segments. Specifically, the set of arm mount segments in FIG.5D includes a lower arm mount segment 530, middle arm mount segment 532,and upper arm mount segment 534. A robotic arm segment 571 (e.g., of therobotic arm 470B in FIG. 4B) is coupled to the upper arm mount segment534. The middle arm mount segment 532 and the upper arm mount segment534 are movably coupled to the lower arm mount segment 530. The lowerarm mount segment 530 is coupled to an arm mount base (e.g., arm mountbase 514 in FIG. 5A).

The surgical robotics system 400B translates the arm mount 506C along anaxis 531 using the arm mount telescoping mechanism 520. In FIG. 5D, theaxis 531 is in a horizontal orientation, though it should be noted that,in other embodiments, the axis 531 is in a vertical or any otherorientation. The arm mount telescoping motor 522 is coupled to the armmount telescoping rail 526. The arm mount telescoping rail 526 isengaged with the arm mount telescoping lead screw 524. The arm mounttelescoping lead screw 524 is stationary relative to the lower arm mountsegment 530. Output rotation of the arm mount telescoping motor 522causes the arm mount telescoping rail 526 to translate along thevertical axis 531. Translation of the arm mount 506C is advantageousbecause, if the arm mount 506C is extended, a robotic arm mounted to thearm mount 506C may have greater access to a patient lying on the table401B during a surgical procedure.

FIG. 5E is an isometric cutaway view of the arm mount 506C in atelescoped configuration according to one embodiment. In the telescopedconfiguration, the upper arm mount segment 534 and the middle arm mountsegment 532 extend in the positive axis 531 direction to facilitateextension of the arm mount 506C.

Alternative views and embodiments of the column ring 505 including theabove mentioned components are further illustrated and described atleast in U.S. Provisional Application No. 62/162,486 filed May 15, 2015and U.S. Provisional Application No. 62/162,467 filed May 15, 2015.

VI. Robotic Arm

FIG. 6A is an isometric view of a robotic arm 670 of a surgical roboticssystem—for example, surgical robotics system 100, 400A, or400B—according to one embodiment. Generally, the robotic arm 670includes a set of robotic arm segments such as robotic arm segments 671,672, 673, 674, 675, 676, and 677. Each arm segment is movably coupled toat least one other arm segment at an arm segment joint. In particular,the first arm segment 671 is movably coupled to the second arm segment672, the second arm segment 672 is movably coupled to the third armsegment 673, and so forth. The first arm segment 671 is movably coupledto an arm mount (e.g., arm mount 506A in FIG. 5A). The seventh armsegment 677 (or the last arm segment of a set of arm segments includinga number of arm segments different than seven), is coupled to a surgicalinstrument. The seventh arm segment 677 may also include mechanisms tohold a surgical instrument such as a clamp or robotic fingers. Therobotic arm 670 uses electrical and mechanical components, such asmotors, gears, and sensors, inside the robotic arm segments to rotatethe arm segments at the arm segment joints.

The robotic arm 670 receives control signals from a robotic arm controlsystem, for example, housed in the column 402B in FIG. 4B. In someembodiments, the robotic arm 670 receives control signals from a roboticarm control system located outside of the column 402B or separate fromthe surgical robotics system 400B. Generally, the robotic arm 670 mayinclude sensors that provide sensor data to the robotic arm controlsystem. Specifically, pressure sensors provide force feedback signalsand encoders or potentiometers provide measurements of rotation of armsegments. The robotic arm control system uses the sensor data togenerate the control signals provided to the robotic arm 670. Since eacharm segment may rotate with respect to another adjacent segment, eacharm segment provides an additional degree of freedom to the mechanicalsystem of the robotic arm 670. By rotating the robotic arm segments, thesurgical robotics system 400B positions a surgical instrument coupled tothe robotic arm 670 such that the surgical instrument has access to apatient undergoing a surgical procedure. Configurations of robotic armsof the surgical robotics system 400B are further described withreference to FIGS. 7A-F in Section VII. System Orientations forPerforming Surgical Procedures.

FIG. 6B is an isometric view of an arm segment joint 610 of the roboticarm 670 according to one embodiment. The first arm segment 671A and thesecond arm segment 672A are embodiments of any of the arm segments inFIG. 6A. The arm segments 671A and 672A are cylindrically shaped andjoined at the plane 612. The first arm segment 671A rotates relative tothe second arm segment 672A about an axis 611 perpendicular to the plane612. Further, the axis 611 is perpendicular to the plane 614 of thesecond arm segment 672A and perpendicular to the plane 616 of the firstarm segment 671A. That is, the axis 611 is longitudinal relative to thearm segments 671A and 672A.

FIG. 6C is an isometric view of another arm segment joint 620 of therobotic arm 670 according to one embodiment. The arm segments 671B and672B are joined at the plane 622. Unlike the cylindrically shaped armsegments shown in FIG. 6B, the arm segments 671B and 672B each include acurved section 628 and 630, respectively. The first arm segment 671Brotates relative to the second arm segment 672B about an axis 621perpendicular to the plane 622. The axis 621 is not perpendicular to theplane 624 of the arm segment 672B and not perpendicular to the plane 626of the arm segment 671B. In some embodiments, the axis of rotation isperpendicular to a plane of one arm segment, but not perpendicular to aplane of the other arm segment of an arm segment joint.

Alternative views and embodiments of the robotic arm 670 including theabove mentioned components are further illustrated and described atleast in U.S. Provisional Application No. 62/162,486 filed May 15, 2015and U.S. Provisional Application No. 62/162,467 filed May 15, 2015.

VII. System Orientations for Performing Surgical Procedures

The surgical robotics system 400B in FIG. 4B performs a variety ofsurgical procedures using column-mounted robotic arms of the set ofrobotic arms. The surgical robotics system 400B configures thecolumn-mounted robotic arms to access portions of a patient lying on thetable 401B before, during, and/or after a surgical procedure. Thecolumn-mounted robotic arms access portions near the groin of thepatient for surgical procedures such as ureteroscopy, percutaneousnephrolithotomy (PCNL), colonoscopy, and fluoroscopy. The column-mountedrobotic arms to access portions near the core (e.g., abdomen) area thepatient for surgical procedures such as prostatectomy, colectomy,cholecystectomy, and inguinal hernia. The column-mounted robotic arms toaccess portions near the head of the patient for surgical proceduressuch as bronchoscopy, endoscopic retrograde cholangiopancreatography(ERCP).

The surgical robotics system 400B automatically reconfigures thecolumn-mounted robotic arms, column rings, column, and table to performdifferent surgical procedures. The features of each subsystem andcomponent of the surgical robotics system 400B enable the same set ofrobotics arms to access a large working volume, and multiple workingvolumes (based on the configuration), to perform a variety of surgicalprocedures on the patient. In particular, as mentioned above, therobotic arms may be configured in a first configuration to access thepatients' groin area, in a second configuration to access the patients'abdomen area, and in a third configuration to access the patients' headarea, in addition to other possible configurations. The degrees offreedom provided by the arm segments of the robotic arms, column rings,column, and table contribute to the wide range of configurations. Thesurgical robotics system 400B includes a computer system that storescomputer program instructions, for example within a non-transitorycomputer-readable storage medium such as a persistent magnetic storagedrive, solid state drive, etc. When executed by a processor of thecomputer system, the instructions cause the components of the surgicalrobotics system 400B to automatically reconfigure without the need forintervention, or with minimal intervention, from a user, e.g., aphysician. For example, based on the instructions, the computer systemsends an electronic control signal to motors of the robotics arms. Inresponse to receiving the control signal, the motors rotate arm segmentsof the robotics arms into a certain position. The physician or anotheruser may design a configuration of the surgical robotics system bycreating the instructions and providing the instructions to the computersystem. For example, the instructions are uploaded to a database of thecomputer system. The automatic configurability of the surgical roboticssystem 400B is an advantage because the automatic configurability savesresources. Specifically, the surgical robotics system 400B reduces theamount of time taken by users to setup the surgical robotics system 400Bfor a surgical procedure. Further, by using the surgical robotics system400B for a variety of surgical procedures, users reduce the amount ofsurgical equipment that they need to purchase, maintain, store, andlearn to operate.

Alternative views and embodiments of use cases of the surgical roboticssystem 400B with column-mounted robotic arms including the abovementioned components are further illustrated and described at least inU.S. Provisional Application No. 62/162,486 filed May 15, 2015 and U.S.Provisional Application No. 62/162,467 filed May 15, 2015.

VII. A. Lower Body Surgery

FIG. 7A is an isometric view of a surgical robotics system 700A withcolumn-mounted arms configured to access the lower body area of apatient 708 according to one embodiment. The surgical robotics system700A is an embodiment of—though includes more components than—thesurgical robotics system 400B in FIG. 4B. Specifically, the surgicalrobotics system 700A includes a set of robotic arms (including fiverobotic arms in total) and a set of three column rings. A first roboticarm 770A and a second robotic arm 770B are coupled to a first columnring 705A. A third robotic arm 770C and a fourth robotic arm 770D arecoupled to a second column ring 705B. A fifth robotic arm 770E iscoupled to a third column ring 705C. FIG. 7A shows a wireframe of thepatient 708 lying on the table 701 undergoing a surgical procedure,e.g., ureteroscopy, requiring access to the lower body area of thepatient 708. Legs of the patient 708 are not shown as to not obscureportions of the surgical robotics system 700A.

The surgical robotics system 700A configures the set of robotic arms toperform a surgical procedure on the lower body area of the patient 708.Specifically, the surgical robotics system 700A configures the set ofrobotic arms to manipulate a surgical instrument 710. FIG. 7A shows theset of robotic arms inserting the surgical instrument 710 along avirtual rail 790 into the groin area of the patient 708. Generally, avirtual rail 790 is a co-axial trajectory along which the set of roboticarms translates a surgical instrument (typically a telescopinginstrument). The second robotic arm 770B, the third robotic arm 770C,and the fifth robotic arm 770E are coupled, e.g., holding, the surgicalinstrument 710. The first robotic arm 770A and the fourth robotic arm770D are stowed to the sides of the surgical robotics system becausethey are not necessarily required to for the surgical procedure—or atleast part of the surgical procedure—shown in FIG. 7A. The robotic armsare configured such that they manipulate the surgical instrument 710from a distance away from the patient 708. This is advantageous, forexample, because there is often limited space available closer towardthe patient's body or there is a sterile boundary around the patient708. Further, there may also be a sterile drape around surgicalequipment. During a surgical procedure, only sterile objects are allowedpass the sterile boundary. Thus, the surgical robotics system 700A maystill use robotic arms that are positioned outside of the sterileboundary and that are covered with sterilized drapes to perform asurgical procedure.

In one embodiment, the surgical robotics system 700A configures the setof robotic arms to perform an endoscopy surgical procedure on thepatient 708. The set of robotic arms hold an endoscope, e.g., thesurgical instrument 710. The set of robotic arms insert the endoscopeinto the patient's body via an opening in the groin area of the patient708. The endoscope is a flexible, slender, and tubular instrument withoptical components such as a camera and optical cable. The opticalcomponents collect data representing images of portions inside thepatient's body. A user of the surgical robotics system 700A uses thedata to assist with performing the endoscopy.

FIG. 7B is a top view of the surgical robotics system 700A withcolumn-mounted arms configured to access the lower body area of thepatient 708 according to one embodiment.

FIG. 7C is an isometric view of an imaging device 740 and a surgicalrobotics system 700B with column-mounted arms configured to access thelower body area of a patient 708 according to one embodiment. Thesurgical robotics system 700B is an embodiment of the surgical roboticssystem 400B in FIG. 4B. The surgical robotics system 700B includes apair of stirrups 720 that support the legs of the patient 708, and thusexposing the groin area of the patient 708. Generally, the imagingdevice 740 captures images of body parts or other objects inside apatient 708. The imaging device 740 may be a C-arm, also referred to asa mobile C-arm, which is often used for fluoroscopy type surgicalprocedures, or another type of imaging device. A C-arm includes agenerator, detector, and imaging system (not shown). The generator iscoupled to the bottom end of the C-arm and faces upward toward thepatient 708. The detector is coupled to the top end of the C-arm andfaces downward toward the patient 708. The generator emits X-ray wavestoward the patient 708. The X-ray waves penetrate the patient 708 andare received by the detector. Based on the received X-ray waves, theimaging system 740 generates the images of body parts or other objectsinside the patient 708. The swivel segment 210 of the table 401B isrotated laterally such that the groin area of the patient 708 is alignedin between the generator and detector of the C-arm imaging device 740.The C-arm is a physically large device with a footprint that needs to bestationed underneath the patient. In particular, the generator of theC-arm needs to be underneath the operative area of the patient, e.g.,the abdomen area. In typical surgical beds mounted to a column, thecolumn interferes with the positioning of the C-arm generator, e.g.,because the column is also underneath the operative area. In contrast,due to the configurability of the swivel segment 210, the surgicalrobotics system 700B may configure the table 401B such that the C-arm,the robotic arms, and a user (e.g., physician) have a sufficient rangeof access to perform a surgical procedure on a working area thepatient's body. In one example use case, the table 401B is translatedlaterally along a longitudinal axis of the table 401B such that therobotic arms can access the groin or lower abdomen area of a patient onthe table 401B. In another example use case, by rotating the swivelsegment 210 away from the column 402B, the generator of the C-arm 740may be positioned underneath the groin area of the patient 708. Theswivel segment 210—with a patient lying on the swivel segment 210—may berotated at least to 45 degrees relative to a longitudinal axis of thetable 401B without tipping over the surgical robotics system. Inparticular, the surgical robotics system does not tip because the centerof mass of the surgical robotics system (e.g., the center of mass of thecombined, at least, table, bed, and base) is positioned above afootprint of the base. Outrigger casters, further described withreference to FIGS. 8G-J in Section VIII. Base, may provide furtherstability to prevent the surgical robotics system from tipping over whena swivel segment is rotated away from the table.

The surgical robotics system 700B uses a set of column-mounted roboticarms to manipulate a surgical instrument 710. Each of the robotic armsis coupled to, e.g., holding, the surgical instrument 710. The surgicalrobotics system 700B uses the robotic arms to insert the surgicalinstrument 710 into the groin area of the patient along a virtual rail790.

FIG. 7D is a top view of the imaging device 740 and the surgicalrobotics system 700B with column-mounted arms configured to access thelower body area of the patient 708 according to one embodiment.

VII. B. Core Body Surgery

FIG. 7E is an isometric view of the surgical robotics system 700B (or400B) with column-mounted arms configured to access the core body areaof a patient 708 according to one embodiment. The surgical roboticssystem 700B has been reconfigured from the configuration shown in FIG.7C-D where the robotic arms access the lower body area of the patient708. In embodiments where the table includes a swivel segment 210, theswivel segment 210 of the table is rotated in-line with the rest of thetable. The patient 708 lying on the table 401B is undergoing a surgicalprocedure, e.g., prostatectomy or laparoscopy, requiring access to thecore body area of the patient 708. Each robotic arm is manipulating asurgical instrument to perform the surgical procedure. The surgicalrobotics system 700B raises the column rings 405B and 405C toward thetable 401B so that the robotic arms have greater access the patient 708.Further, the surgical robotics system 700B rotates the column rings suchthat two of the robotic arms extend from one side of the table 401B andthe other two robotic arms extend from the opposite side of the 401B.Thus, the robotic arms are less likely to interfere with each other(e.g., a robotic arm blocking the motion of another robotic arm) duringthe surgical procedure.

VII. C. Upper Body Surgery

FIG. 7F is an isometric view of the surgical robotics system 700B (or400B) with column-mounted arms configured to access the upper body areaof a patient 708 according to one embodiment. The surgical roboticssystem 700B has been reconfigured from the configuration shown in FIG.7E where the robotic arms access the core body area of the patient 708.In embodiments where the table includes a swivel segment 210, the swivelsegment 210 of the table is rotated in-line with the rest of the table.The patient 708 lying on the table 401B is undergoing a surgicalprocedure, e.g., bronchoscopy, requiring access to the upper body areaof the patient 708, specifically the head of the patient 708. Therobotic arm 470C and the robotic arm 470D are inserting a surgicalinstrument 710D, e.g., a bronchoscope, into the mouth of the patient 708along a virtual rail 790. The robotic arm 470B is coupled to, e.g.,holding, an introducer 750. The introducer 750 is a surgical instrumentthat directs the bronchoscope into the mouth of the patient 708.Specifically, the trajectory of the bronchoscope along the virtual rail790 begins parallel to the patient 708. The introducer 750 changes theangle of the virtual rail 790 just before the bronchoscope enters themouth. The robotic arm 470E (not shown in FIG. 7F) is not used for thesurgical procedure, and thus is stowed away.

VIII. Base

FIG. 8A is an isometric view of a base 403A of a surgical roboticssystem 800A according to one embodiment. The surgical robotics system800A is an embodiment of the surgical robotics system 400B in FIG. 4B.The surgical robotics system 800A stores column-mounted robotic armsand/or column rings (not shown) inside the base 403B when the roboticarms are not in use. The base 403B includes a first panel 820A and asecond panel 820B that cover stored robotic arms. The first panel 820Aand the second panel 820B are advantageous because they prevent wastematerials from de-sterilizing or otherwise contaminating stored roboticarms.

FIG. 8B is an isometric view of open panels of the base 403B accordingto one embodiment. The first panel 820A and the second panel 820B pivotaway from the column 802A such that column-mounted robotic arms haveaccess to inside the base 403B. The first panel 820A includes a cutout830A and the second panel 820B includes a cutout 830B. The cutouts 830Aand 830B conform to the shape of the column 402B such that the panels820A and 820B form a seal around the column 402B when closed. Thesurgical robotics system 800A may automatically open and close the firstpanel 820A and the second panel 820B using motors or other means ofactuation. A user of the surgical robotics system 800A may also manuallyopen and close the first panel 820A and the second panel 820B.

FIG. 8C is an isometric view of a robotic arm stowed inside a base 403Bof a surgical robotics system 800B according to one embodiment. Thesurgical robotics system 800B is an embodiment of the surgical roboticssystem 400B in FIG. 4B. The surgical robotics system 800B storescolumn-mounted robotic arms 470B and 470D and column rings 405B and 405Cinside the base 403B when the robotic arms are not in use. The base 403Bincludes a first panel 820A and a second panel 820B that cover storedrobotic arms and column rings. The first panel 820A includes a cutout830C. The second panel 820B also includes a cutout (not shown due tobeing obscured by other components). The cutouts conform to the shape ofthe column 402B such that the panels 820A and 820B form a seal aroundthe column 402B when closed.

The first panel 820A and a second panel 820B translate laterally toprovide access for the robotic arms and column rings into the base 403B.FIG. 8C shows the first panel 820A and a second panel 820B translated toform an opening. The opening may be large enough to provide access for arobotic arm, but not too large as to still provide protection to therobotic arms even when the panels are open. The robotic arm 470D andcolumn ring 405C are stowed inside the base 403B. The robotic arm 470Band column ring 405B are outside the base 403B, though they may also bestowed inside the base 403B. The surgical robotics system 800B mayautomatically open and close the first panel 820A and the second panel820B using motors or other means of actuation. A user of the surgicalrobotics system 800B may also manually open and close the first panel820A and the second panel 820B.

FIG. 8D is an isometric view of robotic arms stowed underneath the table701 of the surgical robotics system 700A according to one embodiment.Specifically, the arm segments of each robotic arm rotate such that therobotic arm is in a compact configuration for stowage. The surgicalrobotics system 700A raises the first column ring 705A and the secondcolumn ring 705B, and lowers the third column ring 705C toward thecenter of the column 702. This way, the robotic arms have enough spacein the stowed configuration without interfering with each other. In oneembodiment, the column 702 includes covers (e.g., similar to panels 820Aand 820B) over the robotics arms to protect the robotic arms fromcontamination or damage.

FIG. 8E is an isometric view of robotic arms stowed above the base 403Bof the surgical robotics system 400B according to one embodiment. Therobotic arms 470B, 470C, 470D, and 470E are in a stowed configuration.Specifically, the arm segments of each robotic arm rotate such that therobotic arm is in a compact configuration for stowage. The surgicalrobotics system 400B lowers the first column ring 405B and the secondcolumn ring 405C along the column 402B such that the stowed robotic armsrest on the base 403B and are away from the table 401B. A cover (notshown) such as a drape or panel may be used to cover the stowed roboticarms for protection from de-sterilization or other contamination.

FIG. 8F is another isometric view of robotic arms stowed above the base403B of the surgical robotics system 800C according to one embodiment.The robotic arms are rail-mounted instead of column-mounted.Rail-mounted robotic arms are further described with reference to FIGS.9A-B and FIGS. 10A-D in Section IX. Rail-Mounted Robotic Arms andSection X. Rails, respectively. The surgical robotics system 800C is anembodiment of the surgical robotics system 900B further described withreference to FIG. 9B in Section IX. Rail-Mounted Robotic Arms. Therobotic arms 870C, 870D, 870E, 870F, 870G, and 870H are in a stowedconfiguration.

FIG. 8G is an isometric view of outrigger casters on a base 803 of asurgical robotics system according to one embodiment. The base 803 shownin FIG. 8G includes four outrigger casters 840A, 840B, 840C, and 840D,each substantially the same as each other and positioned at a differentcorner of the base 803, though it should be noted that, in otherembodiments, a base may include any number of outrigger casterspositioned in other locations on the base. The outrigger casters 840A,840B, 840C, and 840D are each in a mobile configuration, i.e., thecaster wheel physically contacts the ground. Thus, a user of thesurgical robotics system may transport the surgical robotics systemusing the caster wheels, e.g., to a storage area when the surgicalrobotics system is not in use.

FIG. 8H is another isometric view of the outrigger casters 840A, 840B,840C, and 840D on the base 803 of the surgical robotics system accordingto one embodiment. The outrigger casters 840A, 840B, 840C, and 840D areeach in a stationary configuration, i.e., the outrigger caster isrotated such that the caster wheel does not physically contact theground. Thus, the surgical robotics system may be stabilized andimmobilized during a surgical procedure.

FIG. 8I is a side view of the outrigger caster 840A in a mobileconfiguration according to one embodiment. The outrigger caster 840Aincludes a caster wheel 842 movably coupled to an outrigger mount 844.The outrigger mount 844 is coupled to a foot 846. The first linkage 848is movably coupled to the outrigger mount 844 by the first hinge 850.The second linkage 852 is movably coupled to the outrigger mount 844 bythe second hinge 854. In the mobile configuration, the caster wheel 842may rotate to move the outrigger caster 840 along the ground.

FIG. 8J is a side view of the outrigger caster 840A in a stationaryconfiguration according to one embodiment. In the stationaryconfiguration, the caster wheel 842 may freely rotate, but the casterwheel 842 does not move the outrigger caster 840A because the casterwheel 842 is not physically in contact with the ground. The surgicalrobotics system (or a user) rotates the outrigger caster 840A, e.g., 90degrees, to change the outrigger caster 840A from the mobileconfiguration to the stationary configuration. Thus, the foot 846 nowphysically contacts the ground, and helps prevent the surgical roboticssystem from moving. The foot 846 may have a larger footprint relative tothe caster wheel 842 to provide additional stability on the ground. Thelinkages 848 and 852 are positioned such that they do not interfere withthe rotational path of the outrigger caster 840A. Combining the casterwheel 842 and the foot 846 in the outrigger caster 840A is advantageous,e.g., because the outrigger caster 840A allows the surgical roboticssystem to change between the mobile and stationary configurations usinga compact mechanism, compared to having separate mechanisms for castersand stabilization. Further, in use cases of surgical robotics systemsincluding swivel segments that rotate a patient lying on the swivelsegment away from a corresponding table (e.g., as illustrated in FIGS.7C-D), the feet of outrigger casters (in the stationary configuration)help prevent the surgical robotics system from tipping over due to thecenter of mass of the patient extending beyond the table base.

Alternative views and embodiments of the base 403B including the abovementioned components are further illustrated and described at least inU.S. Provisional Application No. 62/203,530 filed Aug. 11, 2015.

IX. Rail-Mounted Robotic Arms

FIG. 9A is an isometric view of a surgical robotics system 900A with arail-mounted robotic arm according to one embodiment. The surgicalrobotics system 900A includes a set of robotic arms (including at leastarm 470A) and a set of base rails (including at least base rail 980A).The robotic arm 470A is coupled to the base rail 980A. Base rails arefurther described with respect to FIGS. 10A-D in Section X. Rails below.The base rail 980A is movably coupled to the base 103. Thus, the roboticarm 470A may be referred to as a rail-mounted robotic arm 470A.

FIG. 9B is an isometric view of a surgical robotics system 900B withrail-mounted robotic arms according to one embodiment. The surgicalrobotics system 900B includes robotic arms 470B, 470C, 470D, and 470Eeach coupled to a first base rail 980B or a second base rail 980C. Thefirst base rail 980B and the second base rail 980C are movably coupledto the base 103.

In other embodiments, the surgical robotics system 900B may includeadditional or fewer robotic arms and/or base rails. Further, the roboticarms may be coupled to base rails in various configurations. Forexample, three robotic arms may be coupled to a base rail. Additionally,the surgical robotics system 900B may include three base rails eachcoupled to a robotic arm.

The surgical robotics system 900B may translate robotic arms mounted toa base rail by translating the base rails relative to the base 103. Baserails may translate beyond the starting footprint of the base 103, whichallows the robotic arms to operate in a larger volume of space. Further,the surgical robotics system 900B may translate robotic arms mounted toa base rail independently from each other by translating the roboticarms relative to the base rail. This is advantageous, for example,because the surgical robotics system 900B may position the robotic armsin different configurations to perform a variety of surgical procedures.

Alternative views and embodiments of the surgical robotics system 900Bwith rail-mounted robotic arms including the above mentioned componentsare further illustrated and described at least in U.S. ProvisionalApplication No. 62/193,604 filed Jul. 17, 2015 and U.S. ProvisionalApplication No. 62/201,518 filed Aug. 5, 2015.

X. Rails

FIG. 10A is an isometric view of base rails of a surgical roboticssystem 1000 according to one embodiment. A base rail includes a set ofone or more arm mounts each movably coupled to the base rail. Further,each arm mount is an embodiment of the arm mount 506A or 506B previouslydescribed with reference to FIG. 5A in Section V. Column Ring.Specifically, the base rail 980B includes arm mounts 1006A, 1006B, and1006C.

FIG. 10B is an isometric view of arm mounts on the base rail 980Baccording to one embodiment. The arm mounts 1006A, 1006B, and 1006C eachinclude a belt and pinion assembly. Specifically, the belt and pinionassembly of arm mount 1006A includes a bracket 1012, motor 1014, belt1016, and pinion 1018. The belt and pinion assemblies of arm mount 1006Band 1006C are constructed similarly.

The surgical robotics system 1000 translates arm mounts—and thus,robotic arms mounted to the arm mounts—along base rails using the beltand pinion assemblies. Specifically, the arm mount 1006A is movablycoupled to a channel 1020 of the base rail 980B by the bracket 1012. Thebracket 1012 is coupled to motor 1014, belt 1016, and pinion 1018. Themotor 1014 is coupled to the pinion 1018 by the belt 1016. Thus, outputrotation of the motor 1014 causes the pinion 1018 to rotate. The pinion1018 is engaged with a rail lead screw 1010 of the base rail 980B.Rotation of the pinion 1018 causes the arm mount 1006A to translatealong the base rail 980B parallel to the rail lead screw 1010.

FIG. 10C is an isometric cutaway view of an arm mount 1006A on the baserail 980B according to one embodiment. The arm mount 1006A includes abelt and pinion assembly. Specifically, the belt and pinion assemblyincludes a motor 1014, belt 1016, pinion 1018, and bearing 1022. Thesurgical robotics system 1000 translates the arm mount 1006A—and thus, arobotic arm mounted to the arm mount 1006A—along the base rail 980Busing the belt and pinion assembly. The motor 1014 is coupled to thepinion 1018 by the belt 1016. Thus, output rotation of the motor 1014causes the pinion 1018 to rotate. The pinion 1018 is coupled to thebearing 1022. In some embodiments, the bearing 1022 forms a rack andpinion assembly with the base rail 980B. Specifically, the bearing 1022is a gear (i.e., the pinion) and is engaged with a rack 1024 of the baserail 980B. Rotation of the pinion 1018 causes the bearing 1022 totranslate along the base rail 980B parallel to the rack 1024. Thus, thearm mount 1006A also translates along the base rail 980B.

FIG. 10D is cross sectional views of the base rail 980B according to oneembodiment. The cross sectional view 1000A shows a basic profile of anembodiment of the base rail 980B. The cross sectional view 1000B shows areinforced profile of an embodiment of the base rail 980B. The lowersegment 1030B of the reinforced profile is larger in size than the lowersegment 1030A of the basic profile. Thus, the reinforced profile is anadvantage, for example, because it enables the base rail 980B towithstand greater loads relative to the basic profile. Both the basicand the reinforced profiles have a T-slot attachment 1040, which engageswith a corresponding T-slot on a base of a surgical robotics system.

Alternative views and embodiments of the base rails 980A, 980B, and 980Cincluding the above mentioned components are further illustrated anddescribed at least in U.S. Provisional Application No. 62/193,604 filedJul. 17, 2015 and U.S. Provisional Application No. 62/201,518 filed Aug.5, 2015.

XI. Alternate Configurations XI. A. Hybrid Configuration

FIG. 11 is an isometric view of a surgical robotics system 1100 withcolumn-mounted robotics arms and rail-mounted robotic arms according toone embodiment. Due to the hybrid configuration including bothcolumn-mounted robotics arms and rail-mounted robotic arms, the surgicalrobotics system 1100 may configure the robotic arms in a greater numberof (or different types of) positions compared to surgical roboticssystems with column-mounted robotics arms only or rail-mounted roboticarms only. Further, the surgical robotics system 1100 takes advantage ofthe rotational motion of robotic arms using the column rings as well astranslational motion of the robotic arms using the base rails.

XI. B. Cart-Based Robotic Arm Column

FIG. 12 is an isometric view of a surgical robotics system 1200 withcolumn-mounted robotics arms on a column 402B and base 403B separate,e.g., as a free standing cart, from a table 101, column 102, and base103 of the surgical robotics system 1200 according to one embodiment.The surgical robotics system 1200 configures the robotic arms to accessthe lower body area of patient 708 lying on the table 101. In oneembodiment, mounting the robotic arms on a cart including the column402B separate from the column 102 coupled to the table 101 with thepatient is advantageous. For example, because the surgical roboticssystem 1200 may configure the robotic arms to a greater number of (ordifferent types of) positions compared to surgical robotics systems withrobotics arms mounted to the same column as the table, which are limitedat least in the angles where the table extends past the column 102.Further, the cart may include outrigger casters (e.g., previouslydescribed with reference to FIGS. 8G-J in Section VIII. Base) that allowusers to more easily transport the robotic arms or keep the cartstationary. Mounting the robotic arms separately can also reduce thenumber of components and complexity of the column coupled to the tablewith the patient.

Alternative views and embodiments of the surgical robotics system 1100,the surgical robotics system 1200, and other surgical robotics systemsincluding the above mentioned components are further illustrated anddescribed at least in U.S. Provisional Application No. 62/162,486 filedMay 15, 2015, U.S. Provisional Application No. 62/162,467 filed May 15,2015, U.S. Provisional Application No. 62/193,604 filed Jul. 17, 2015,U.S. Provisional Application No. 62/201,518 filed Aug. 5, 2015, U.S.Provisional Application No. 62/203,530 filed Aug. 11, 2015, and U.S.Provisional Application No. 62/235,394 filed Sep. 30, 2015.

XII. Adjustable Arm Supports

Robotic surgical systems can include adjustable arm supports asdescribed in this section for supporting one or more robotic arms. Theadjustable arm supports can be configured to attach to either a table, acolumn support of the table, or a base of the table to deploy theadjustable arm supports and robotic arms from a position below thetable. In some embodiments, the adjustable arm supports can be attachedto a bed (or table) or a cart positioned adjacent to a bed. In someexamples, the adjustable arm supports includes a bar, track, or rail onwhich one or more robotic arms are mounted. In some embodiments, theadjustable arm supports include at least four degrees of freedom thatallow for adjustment of the position of the bar, track, or rail. One ofthe degrees of freedom can allow the adjustable arm supports to beadjusted vertically relative to the table. These and other features ofthe adjustable arm supports will be described in detail with referenceto the examples of FIGS. 13A-21.

FIGS. 13A and 13B are isometric and end views, respectively, of asurgical robotics system 1300 that includes an adjustable arm support1305 according to one embodiment. The adjustable arm support 1305 can beconfigured to support one or more robotic arms (see, for example, FIGS.14A-15B) relative to a table 1301. As will be described in greaterdetail below, the adjustable arm support 1305 can be configured so thatit can move relative to the table 1301 to adjust and/or vary theposition of the adjustable arm support 1305 and/or any robotic armsmounted to the adjustable arm support 1305 relative to the table 1301.For example, the adjustable arm support 1305 may include one or moredegrees of freedom relative to the table 1301 to allow adjustment of theadjustable arm support 1305. Although the system 1300 illustrated inFIGS. 13A and 13B includes only a single adjustable arm support 1305, insome embodiments, systems can include multiple adjustable arm supports(see, e.g., system 1400 of FIG. 14A, which includes two adjustable armsupports 1305A, 1305B).

Surgical robotics systems including adjustable arm supports 1305 asdescribed in this section can be designed to address one or more issuesof known surgical robotics systems. For example, one issue with somesurgical robotics systems is that they may be bulky, occupying largeamounts of room space. This is often because large and elaborate supportstructures have been necessary to position robotic arms to performrobotic surgical procedures. Some surgical robotics systems includerobotic arm support structures that support a plurality of robotic armsabove a table that supports a patient during the robotic surgicalprocedure. For example, common surgical robotics systems include supportstructures that suspend one or more robotic arms over a table. Thesesupport structures are quite large and bulky because, for example, theymust extend over and above the table.

Another issue with some surgical robotics systems is that they can beoverly cumbersome. Due to, for example, the large and bulky supportstructures required by some surgical robotics systems as describedabove, these systems are not easily moved, which can be disadvantageous.Before and after surgery, it can be desirable to quickly and smoothlyclear the robotic arms from a surgical area to provide easy access forloading a patient onto or removing a patient from the table. This hasproven to be difficult with some surgical robotics systems because ofthe large and bulky support structures and the cumbersome nature ofthese systems. Some surgical robotics systems are not easily stored ormoved.

Further, some surgical robotics systems have limited flexibility orversatility. That is, some surgical robotics systems are designed for aparticular surgical procedure, and accordingly, do not work well forother types of surgical procedures. For example, a surgical roboticssystem that is configured for laparoscopic surgery may not work well forendoscopic surgery, or vice versa. In some instances, this is becausethe robotic arms used during the procedures need to be positioned indifferent locations relative the patient and/or table during differenttypes of surgical procedures, and the support structures of conventionalsurgical robotics systems are not capable of accommodating the differentpositions of the robotic arms. Further, as mentioned above, somesurgical robotics systems include support structures that suspend one ormore robotic arms above the patient and table. It may be difficult toperform certain medical procedures with robotic arms mounted in thisposition.

Finally, some surgical robotics systems include robotic arms that arefixedly mounted to their corresponding support structures, and/orsupport structures themselves that are fixedly mounted or positioned.These systems may rely on articulation of the robotic arms alone toadjust the position of the robotic arms and/or surgical tools mountedthereto. Because the arms and/or supports are fixed in position, thiscan greatly limit the overall flexibility of these systems. The fixednature of the robotic arms and/or supports of some systems may furtherlimit the ability of these systems to avoid collisions between the armsand/or other objects (e.g., the patient, the table, other equipment,etc.) during surgery.

The system 1300 of FIGS. 13An and 13B including the adjustable armsupport 1305, as well as the other systems described in this section,can be configured to address (e.g., reduce or eliminate) one or more ofthe issues associated with some surgical robotics systems discussedabove. For example, the systems described herein can be less bulky thansome systems. The systems described herein can occupy less physicalspace than some systems. The systems described herein can be lesscumbersome than some systems. For example, the systems described hereincan be readily mobile and/or can be configured to store the arm supportsand robotic arms quickly and easily to allow convenient access to thepatient and/or table. The systems described herein can be highlyflexible and configured for use in a wide variety of surgicalprocedures. For example, in some embodiments, the systems are configuredfor both laparoscopic and endoscopic procedures. The systems describedherein can be configured to reduce collisions between the variousrobotic arms and other objects in the operating room.

In some embodiments, one or more of these advantages can be achieved byinclusion of one or more adjustable arm supports 1305 as describedherein. As mentioned above, the adjustable arm supports 1305 can beconfigured so as to be able to move relative to the table 1301 to adjustand/or vary the position of the adjustable arm support 1305 and/or anyrobotic arms mounted to the adjustable arm support 1305 relative to thetable 1301. For example, the adjustable arm supports 1305 can be capableof being stowed (for example, below the table 1301) and subsequentlyelevated for use. In some embodiments, the adjustable arm supports 1305can be stowed in or near a base that supports the table 1301. In someembodiments, the adjustable arm supports 1305 can be stowed in one ormore recesses formed along a central longitudinal axis of the base. Inother embodiments, the adjustable arm supports 1305 can be stowed in oneor more recesses offset from a central longitudinal axis of the base.Upon elevation, the adjustable arm supports 1305 can be positioned nearthe patient, but below the table 1301 (e.g., below the upper surface ofthe table 1301). In other embodiments, the arm supports 1305 can beraised above the table 1301 (e.g., above the upper surface of thetable). Such a configuration can be useful, for example, when anadjustable arm support is positioned behind a patient lying on his side.

In some embodiments, the adjustable arm support 1305 is attached to thebed with a support structure that provides several degrees of freedom(e.g., lift, lateral translation, tilt, etc.). In the illustratedembodiment of FIGS. 13A and 13B, the arm support 1305 is configured withfour degrees of freedom, which are illustrated with arrows in FIG. 13A.A first degree of freedom allows for adjustment of the adjustable armsupport in the z-direction (“Z-lift”). For example, as will be describedbelow, the adjustable arm support 1305 can include a carriage 1309configured to move up or down along or relative to a column 1302supporting the table 1301. A second degree of freedom can allow theadjustable arm support 1305 to tilt. For example, the adjustable armsupport 1305 can include a rotary joint, which can, for example, permitthe arm support 1305 to be aligned with a bed in a Trendelenburgposition. A third degree of freedom can allow the adjustable arm supportto pivot up as shown. As will be described below, this degree of freedomcan be used to adjust a distance between the side of the table 1301 andthe adjustable arm support 1305. A fourth degree of freedom can permittranslation of the adjustable arm support 1305 along a longitudinallength of the table. Arm supports 1305 that include one or more of thesedegrees of freedom can address one or more of the issues associated withsome systems noted above by providing a highly positionable support towhich various robotic arms can be attached. The adjustable arm support1305 can allow for adjustment of the position of the robotic armsrelative to, for example, the table 1301. In some embodiments, thesedegrees of freedom can be controlled serially, in which one movement isperformed after another. In other embodiments, different degrees offreedom can be controlled in parallel. For example, in some embodiments,one or more linear actuators can provide both Z-lift and tilt.

These degrees of freedom, as well as other features of the adjustablearm support 1305, will now be described in greater detail with referenceto FIGS. 13A and 13B, which are isometric and end views, respectively,of the surgical robotics system 1300, which includes the adjustable armsupport 1305 according to one embodiment. In the illustrated embodiment,the system 1300 includes the table 1301. In some embodiments, the table1301 may be similar to the tables described above. In the illustratedembodiment, the table 1301 is supported by a column 1302, which ismounted to a base 1303. The base 1303 can be configured to rest on asupport surface, such as a floor. Thus, the base 1303 and the column1302 support the table 1301 relative to the support surface. FIG. 13B,illustrates a support surface plane 1331. In some embodiments, the table1301 can be supported by one or more supports, wherein one of thesupports comprises the column 1302. For example, the table 1301 can besupported by a Stewart mechanism comprising a plurality of parallelactuators.

The system 1300 can also include the adjustable arm support 1305. In theillustrated embodiment, the adjustable arm support 1305 is mounted tothe column 1302. In other embodiments, the adjustable arm support 1305can be mounted to the table 1301 or the base 1303. As mentioned above,the adjustable arm support 1305 is configured so that the position ofthe adjustable arm support 1305 can be adjusted relative to the table1301. In some embodiments, the position of the adjustable arm support1305 can also be adjusted relative to the column 1302 and/or base 1303.

The adjustable arm support 1305 can include a carriage 1309, a bar orrail connector 1311, and a bar or rail 1307. The bar or rail 1307 cancomprise a proximal portion and a distal portion. One or more roboticarms can be mounted to the rail 1307, as shown, for example, in FIGS.14A-15B. For example, in some embodiments, one, two, three, or morerobotic arms can be mounted to the rail 1307. Further, in someembodiments, the robotic arms that are mounted to the rail can beconfigured to move (e.g., translate) along the rail 1307, such that theposition of the robotic arms on the rail 1307 can be adjusted relativeto one another, thereby reducing the risk of collision between therobotic arms. This will be described in greater detail below. In theillustrated embodiment, the rail 1307 is connected to the bar or railconnector 1311. The bar or rail connector 1311 is connected to thecarriage 1309. The carriage is connected to the column 1302. Otherarrangements are possible.

The column 1302 can extend along a first axis 1323. In some embodiments,the first axis 1323 is parallel to the z-axis as illustrated. In someembodiments, the first axis 1323 is a vertical axis. For example, thefirst axis 1323 can be perpendicular to the support surface or floor onwhich the system 1300 rests.

The carriage 1309 can be attached to the column 1302 by a first joint1313. The first joint 1313 can be configured to allow the carriage 1309(and accordingly the adjustable arm support 1305) to move relative tothe column 1302. In some embodiments, the first joint 1313 is configuredto allow the carriage 1309 to move along the column 1302 (for example,up and down along the column 1302). In some embodiment, the first joint1313 is configured to allow the carriage 1309 to move along the firstaxis 1323 (for example, back and forth along the first axis 1323). Thefirst joint 1313 can comprise a linear or prismatic joint. The firstjoint 1313 can comprise a powered joint, such as a motorized orhydraulic joint. The first joint 1313 can be configured to provide thefirst degree of freedom (“Z-lift”) for the adjustable arm support 1305.

The adjustable arm support 1305 can include a second joint 1315 asshown. The second joint 1315 can be configured to provide the seconddegree of freedom (tilt) for the adjustable arm support 1305. The secondjoint 1315 can be configured to allow the adjustable arm support 1305 torotate around a second axis 1325 that is different than the first axis1323. In some embodiments, the second axis 1325 is perpendicular to thefirst axis 1323. In some embodiments, the second axis 1325 need not beperpendicular relative to the first axis 1323. For example, in someembodiments, the second axis 1325 is at an acute angle to the first axis1323. In some embodiments, the second axis 1325 extends in they-direction. In some embodiments, the second axis 1325 may lie in aplane that is parallel to the support surface or floor on which thesystem 1300 rests. The second joint 1315 can comprise a rotationaljoint. The second joint 1315 can comprise a powered joint, such as amotorized or hydraulic joint.

In the illustrated embodiment, the second joint 1315 is formed betweenthe carriage 1309 and the column 1302, such that the carriage 1309 canrotate about the second axis 1325 relative to the column 1302. In otherembodiments, the second joint 1315 can be positioned in other locations.For example, the second joint 1315 can be positioned between thecarriage 1309 and the rail connector 1311, or between the rail connector1311 and the rail 1307.

As noted above, the second joint 1315 can be configured to allow theadjustable arm support 1305 to rotate about the second axis 1325 toallow for the second degree of freedom (tilt) for the adjustable armsupport 1305. As will be described in greater detail with reference toFIG. 16 below, rotating the adjustable arm support 1305 about the secondaxis 1325 can allow adjustment of a tilt angle of the adjustable armsupport 1305. That is, an angle of tilt of the rail 1307 can be adjustedby rotating the adjustable arm support 1305 about the second axis 1325(see FIG. 16).

The adjustable arm support 1305 can include a third joint 1317 as shown.The third joint 1317 can be configured to provide the third degree offreedom (pivot up) for the adjustable arm support 1305. The third joint1317 can be configured as a rotational joint to allow the rail connector1311 to rotate around a third axis 1327 that is different from the firstaxis 1323 and the second axis 1325. In some embodiments, the third axis1327 can be perpendicular to the second axis 1325. In other embodiments,the third axis 1327 need not be parallel to the second axis 1325. Forexample, the third axis 1327 can be at an acute angle relative to thesecond axis 1325. In some embodiments, the third axis 1327 extends inthe x-direction. In some embodiments, the third axis 1327 may lie in aplane that is parallel to the support surface or floor on which thesystem 1300 rests. The third axis 1327 may lie in the same plane or adifferent plane than the second axis 1325. When the adjustable armsupport 1305 is positioned as shown in FIGS. 13A and 13B, the third axis1327 can be perpendicular to the first axis 1323; however, as theadjustable arm support 1305 is rotated about the second joint 1315, theangle between the first axis 1323 and the third axis 1327 can vary. Insome embodiments, the third axis 1327 can be parallel to the rail 1307.

When configured as a rotational joint, the third joint 1317 can allowthe rail connector 1311 to rotate around the third axis 1327. As therail connector 1311 rotates around the third axis 1327, a distance (forexample, measured along the y-direction) between an edge of the table1301 and the rail 1307 can be adjusted. For example, the distancebetween the edge of the table 1301 and the rail 1307 would increase asthe rail connector 1311 is rotated downward from the position shown inFIG. 13B. Thus, the third joint 1317 can be configured to provide adegree of freedom that allows adjustment of the positioning of the rail1307 along the y-direction. Further, when configured as a rotationaljoint, the third joint 1317 can also allow additional adjustment of theposition of the rail 1307 along the z-direction. For example, the heightof the rail 1307 (along the z-direction) would decrease as the railconnector 1311 is rotated downward from the position shown in FIG. 13B.In some embodiments, the third joint 1317 can allow the rail 1307 topivot upwards in a “biceps curl” type fashion from a stowed position toan elevated position.

As best seen in FIG. 13B, in the illustrated embodiment, the third joint1317 is positioned on a first end of the rail connector 1311 thatconnects the rail connector 1311 to the carriage. An additional joint1319 can be included at a second end of the rail connector 1311 thatconnects the rail connector 1311 to the rail 1317. In some embodiments,the position of the third joint 1317 and the additional joint 1319 canbe reversed. In some embodiments, the additional joint 1319 ismechanically constrained to the third joint 1317 such that the thirdjoint 1317 and the additional joint 1319 rotate together. For example,the third joint 1317 and the additional joint 1319 can be mechanicallyconstrained via a four-bar linkage. Other methods for mechanicalconstraint are also possible. Mechanical constraint between the thirdjoint 1317 and the additional joint 1319 can be configured to maintainan orientation of the rail 1307 as the rail connector 1311 is rotatedabout the third axis 1327. For example, mechanical constraint betweenthe third joint 1317 and the additional joint 1319 can be configuredsuch that, as the rail connector 1311 rotates, an upper surface of therail 1307 (to which one or more robotic arms can be mounted) continue toface in the same direction. In the illustrated example of FIGS. 13A and13B, the upper face of the rail 1307 is facing upwards (in thez-direction). Mechanical constraint between the third joint 1317 and theadditional joint 1319 can be configured such that the upper face of therail 1307 remains facing upwards (in the z-direction) as the railconnector 1311 rotates. In some embodiments, mechanical constraint canbe replaced with a software-defined constrained. For example, each ofthe third joint 1317 and the additional joint 1319 can be a poweredjoint, and software can be used to constrain rotation of each jointtogether.

In some embodiments, the third joint 1317 can comprise a linear joint orprismatic joint (in place of the rotation joint described above andillustrated in the figures) configured to allow linear displacement ofthe rail 1307 toward and away from the column 1302 (for example, alongthe y-direction).

The third joint 1317 can comprise a powered joint. In some embodiments,the third joint 1317 can comprise a motorized or hydraulic joint.

The adjustable arm support 1305 can include a fourth joint 1321 asshown. The fourth joint 1321 can be configured to provide the fourthdegree of freedom (translation) for the adjustable arm support 1305. Forexample, the fourth joint 1321 can be configured to allow the rail 1307to translate back and forth relative to, for example, the table 1301,the column 1302, the carriage 1309, and/or the rail connector 1311. Therail 1307 can extend along a fourth axis 1329. The fourth joint 1321 canbe configured to allow the rail 1307 to translate along the fourth axis1329. In some embodiments, the fourth axis 1329 can be parallel to thirdaxis 1327. In other embodiments, the fourth axis 1329 can be at anon-parallel (e.g., acute angle) to third axis 1327. In someembodiments, the fourth axis 1329 can be perpendicular to the secondaxis 1325. In other embodiments, the fourth axis 1329 can be at anon-perpendicular angle (e.g., acute angle) to the second axis 1325.When the adjustable arm support 1305 is positioned as shown in FIGS. 13Aand 13B, the fourth axis 1329 can be perpendicular to the first axis1323; however, as the adjustable arm support 1305 is rotated about thesecond joint 1315, the angle between the first axis 1323 and the fourthaxis 1329 can vary.

The fourth joint 1321 can comprise a linear or prismatic joint. Thefourth joint 1321 can comprise a powered joint, such as a motorized orhydraulic joint. In the illustrated embodiment, the fourth joint 1321 ispositioned between the bar or rail connector 1311 and the rail 1307.

As will be described in greater detail below with reference to FIGS. 15Aand 15B, translation of the rail 1307 can be configured to provideincreased longitudinal reach (for example, along the x-direction) forthe system 1300. This may improve the flexibility of the system 1300,allowing the system 1300 to be used in a wider variety of surgicalprocedures.

In some embodiments, the adjustable arm support 1305 is configured toallow for variable positioning of the rail 1307 relative to the table1301. In some embodiments, the position of the rail 1307 remains below atable support surface plane 1333 that is parallel with an upper surfaceof the table 1301. This may be advantageous as it may improve theability to maintain a sterile field above the table support surfaceplane 1333 during a medical procedure. In the operating environment,medical personal may desire to maintain a sterile field above thesurface of the table. As such, there may be heightened requirements orstricter procedures for equipment that is positioned above the surfaceof the table. For example, equipment positioned above the surface of thetable may need to be draped. As such, it may be desirable, and somemedical personal may prefer, that the arm support is maintained belowthe surface of the table. In some instances, when the arm support ismaintained below the surface of the table, it may not need to be draped.In other embodiments, however, the adjustable arm support 1305 canadjust the position of the rail 1307 such that it is positioned abovethe table support surface plane 1333.

In some embodiments, the adjustable arm support 1305 is attached to thebase 1303, the column 1302, or the table 1301 at a position below thetable support surface plane 1333. As will be described below withreference to FIGS. 18A and 18B, this may advantageously permit theadjustable arm support 1305 (and any attached robotic arms) to be movedto a stowed configuration in which the adjustable arm support 1305 (andany attached robotic arms) are stowed below the table 1301 (see FIG.18B). This may advantageously make the system 1300 less bulky and/orless cumbersome when compared to previously known surgical roboticssystems.

Movement of the arm support 1305 (for example, movement of one or moreof the first, second, third, or fourth joints 1313, 1315, 1317, 1321)may be controlled and/or commanded in several ways. For example, thesystem 1300 can include a controller (e.g., a pendant) either on the bed(patient side) or a surgeon console. As another example, buttons (orother actuation mechanisms) could be included on one or more of thecomponents of the adjustable arm support 1305 (or on one or more of theconnected robotic arms). As another example, movement of the adjustablearm support 1305 can be provided automatically by system software, forexample, for adjustment within the robot's null space (while maintainingthe tooltip position commanded by the surgeon). Additionally, movementof the adjustable arm support 1305 can be provided automatically bysystem software during setup, deployment, draping, or other workflowsteps when tools are not inserted into the patient. Other examples arealso possible.

FIGS. 13A and 13B illustrate an embodiment that includes one adjustablearm support 1305. As noted previously, some systems can include morethan one adjustable arm support 1305, each supporting one or morerobotic arms. In such systems, each adjustable arm support can beconfigured as described above. Further, in such systems, each adjustablearm support can be controlled independently.

FIG. 14A is an end view of a surgical robotics system 1400A with twoadjustable arm supports 1305A, 1305B mounted on opposite sides of thetable 1301 according to one embodiment. Each of the adjustable armsupports 1305A, 1305B can be configured as described above. In theillustrated embodiment, a first adjustable arm support 1305A ispositioned on a first side of the table 1301 (e.g., the right side asshown in the figure), and a second adjustable arm support 1305B ispositioned on a second side of the table 1301 (e.g., the left side asshown in the figure). The second side can be opposite the first side.

Further, a first robotic arm 1402A is illustrated attached to the bar orrail 1307A of the first adjustable arm support 1305A, and a secondrobotic arm 1402B is illustrated attached to the bar or rail 1307B ofthe second adjustable arm support 1305B. As illustrated, the firstrobotic arm 1402A includes a base 1404A attached to the rail 1307A. Thedistal end of the first robotic arm 1402A includes an instrument drivemechanism 1406A. The instrument drive mechanism 1406A can be configuredto attach to one or more robotic medical instruments or tools.Similarly, the second robotic arm 1402B includes a base 1404B attachedto the rail 1307B. The distal end of the second robotic arm 1402Bincludes an instrument drive mechanism 1406B. The instrument drivemechanism 1406B can be configured to attach to one or more roboticmedical instruments or tools. Example robotic arms configured for usewith the adjustable arm supports 1305 are described below in greaterdetail in Section XIII (see FIG. 21).

FIG. 14A illustrates that the adjustable arm supports 1305A, 1305B canbe independently controlled and positioned. As illustrated, the firstadjustable arm support 1305A is positioned at a first height along thefirst axis 1323, and the second adjustable arm support 1305B ispositioned at a second height along the first axis 1323. In someembodiments, the second height can be different and independent from thefirst height. In other embodiments, the second height can besubstantially equivalent to the first height.

In the embodiment in FIG. 14A, the carriage 1309A of the firstadjustable arm support 1305A is positioned at a first height along thefirst axis 1323, and the carriage 1309B of the second adjustable armsupport 1305B is positioned at a second height along the first axis 1323different than the first height. Thus, a height difference H1 can existbetween the carriages 1309A, 1309B of the first and second adjustablearm supports 1305A, 1305B. In other embodiments, the carriages 1309A,1309B of the first and second adjustable arm supports 1305A, 1305B canbe positioned at the same height.

Further, FIG. 14A illustrates the position of the bar or rail connectors1311A, 1311B of the first and second adjustable arm supports 1305A,1305B, which can also be independently adjusted to have differentorientations. For example, as illustrated, the rail connector 1311A ofthe first adjustable arm support 1305A is rotated downwardly, and therail connector 1311B of the second adjustable arm support 1305B isrotated upwardly. A height difference H2 can exist between the rails1307A, 1307B of the first and second adjustable arm supports 1305A,1305B, as illustrated. Further, in this position, each of the railconnectors 1311A, 1311B, of the first and second adjustable arm supports1305A, 1305B is positioned at a different distance from the first axis1323. For example, the rail connector 1311A of the first adjustable armsupport 1305A is positioned at a first distance D1 from the first axis1323, and the rail connector 1311B of the second adjustable arm support1305B is positioned at a second distance D2 from the first axis 1323.This distance D1 can be different than the distance D2. In someembodiments, the rail connectors 1311A, 1311B, of the first and secondadjustable arm supports 1305A, 1305B can be rotated to the same degreeand/or the distance D1 can be equal to the distance D2.

FIG. 14A illustrates that the adjustable arm supports 1305A, 1305B caneach be positioned or adjusted independently to provide differentpositions at which the robotic arms attached thereto are supported. FIG.14A illustrates only one example among many. The adjustable arm supports1305 can have continuous movement (e.g., vertical or longitudinal) andcan be stopped at any point as desired by a surgeon or clinician. Thiscan be beneficial, for example, in creating a height differentialbetween the arm supports, which can be advantageous for certain types ofsurgeries, such as when one set of robotic arms needs to reach low andthe other needs to reach over a patient. For example, as shown in FIG.14A, the second adjustable arm support 1305B with attached robotic arm1402B is raised higher than the first adjustable arm support 1305A withattached robotic arm 1402A. This position may be especially helpful whenthe patient is on its side (e.g., lateral decubitus), such as in anephrectomy procedure, although one skilled in the art will appreciatethat a differential can be beneficial in other procedures as well. FIGS.14B and 14C provide additional examples.

FIG. 14B is an isometric view of a surgical robotics system 1400B withtwo adjustable arm supports 1305A, 1305B and a plurality of robotic arms1402A, 1402B, 1402C, 1402D configured for a laparoscopic procedureaccording to one embodiment. In the illustrated embodiment, a firstadjustable arm support 1305A supports a first robotic arm 1402A, and asecond adjustable arm support 1305B supports a second robotic arm 1402B,a third robotic arm 1402C, and a fourth robotic arm 1402D.

The first robotic arm 1402A can be configured to translate back andforth along the rail 1307A of the first adjustable arm support 1305A.That is, the first robotic arm 1402A can be configured to translatealong the fourth axis 1329A. This can allow for adjustment of the firstrobotic arm 1402A relative to the rail 1307A. Similarly, the secondrobotic arm 1402B, the third robotic arm 1402C, and the fourth roboticarm 1402D can each be configured to translate back and forth along therail 1307B of the second adjustable arm support 1305B. That is, thesecond robotic arm 1402B, the third robotic arm 1402C, and the fourthrobotic arm 1402D can be configured to translate along the fourth axis1329B of the second adjustable arm support 1305B. This can allow foradjustment of the second robotic arm 1402B, the third robotic arm 1402C,and the fourth robotic arm 1402D relative to the rail 1307B. Further,each of the second robotic arm 1402B, the third robotic arm 1402C, andthe fourth robotic arm 1402D can be independently moved along the rail1307B such that the spacing between each of the second robotic arm1402B, the third robotic arm 1402C, and the fourth robotic arm 1402D canbe adjusted. Among other things, FIG. 14B illustrates that in someembodiments, the position of each robotic arm 1402 along thecorresponding rail 1307 of the corresponding arm support 1305 can beindependently controlled and adjusted.

Further, FIG. 14B illustrates another example of a height differentialbetween the first and second arm supports 1305A, 1305B. In theillustrated embodiment, a patient 10 is positioned on his or her sideduring a laparoscopic procedure. The first adjustable arm support 1305Ais positioned in a high position (but below the surface of the table1301) such that the first robotic arm 1402A can reach over the patient10. As illustrated, the second adjustable arm support 1305B ispositioned at a lower position such that the second robotic arm 1402B,the third robotic arm 1402C, and the fourth robotic arm 1402D can accessan anterior side of the patient.

In some embodiments, one or more of the robotic arms 1402A, 1402B,1402C, 1402D can operate laparoscopic surgical instruments or tools, andone or more of the other of the 1402A, 1402B, 1402C, 1402D can operate acamera laparoscopically inserted into the patient. In some embodiments,the one or more laparoscopic surgical instruments and the camera can besized and configured to extend through one or more laparoscopic ports ina patient.

FIG. 14C is an isometric view of a surgical robotics system 1400C withtwo adjustable arm supports 1305A, 1305B and a plurality of robotic arms1402A, 1402B, 1402C, 1402D, 1402E configured for a laparoscopicprocedure according to one embodiment. In the illustrated embodiment, afirst adjustable arm support 1305A supports a first robotic arm 1402Aand a second robotic arm 1402B, and a second adjustable arm support1305B supports a third robotic arm 1402C, a fourth robotic arm 1402D,and a fifth robotic arm 1402E.

In the illustrated embodiment, the table 1301 supporting the patient 10is positioned at an angle relative to the floor. That is, rather thanbeing parallel, as illustrated for example, in FIG. 14B, a table surfaceplane 1333 is angled with respect to a support surface plane 1331. Thefirst adjustable arm support 1305A, positioned on the lower side of thetable 1301, can be positioned in a low position such that the firstrobotic arm 1402A and the second robotic arm 1402B can access thepatient 10. As illustrated, the second adjustable arm support 1305B ispositioned at a higher position (which may be lower than the tablesupport surface 1333) such that the third robotic arm 1402C, the fourthrobotic arm 1402D, and the fifth robotic arm 1402E can reach over andaccess the patient 10.

FIG. 15A is an isometric view of a surgical robotics systems with twoadjustable arm supports 1305A, 1305B that are configured to translate toadjust the position of the adjustable arm supports 1305A, 1305Baccording to one embodiment. As described previously, the adjustable armsupport 1305 can include a fourth joint 1321 configured to allow therail 1307 to translate along the fourth axis 1329 relative to the base1302, column 1302, table 1301, carriage 1309, and/or rail connector1311. FIG. 15A illustrates that, in embodiments that include twoadjustable arm supports 1305A, 1305B, the rail 1307A, 1307B of eachadjustable arm support 1305A, 1305B can be translated along itscorresponding axis 1329A, 1329B, independently of the other rail. Forexample, in FIG. 15A, the rail 1307A can translate back and forth alongthe axis 1329A, independently from the rail 1307B, which can alsotranslate back and forth along the axis 1329B.

In other embodiments, rails 1307 are not configured to translate alongthe axis 1329. For example, in some embodiments, longer rails 1307 canbe used in lieu of translating rails. In some embodiments, translationof the rails 1307 permits shorter rails 1307 to be used while stillmaintaining the overall versatility and flexibility of the system. Insome embodiments, shorter rails 1307 (with or without translation) canimproved the ability of system to be stowed below the table 1301 (seeFIG. 18B).

FIG. 15B is an isometric view of a surgical robotics system 1500B withan adjustable arm support 1305 and robotic arm 1402 configured for anendoscopic procedure according to one embodiment. FIG. 15B illustratesthat, in some embodiments, a system including an adjustable arm support1305 can be configured to provide a long longitudinal range of motionthat can be useful, for example, in an endoscopic procedure, such as aureteroscopy, wherein an endoscope is inserted into the patient throughthe groin area. For example, as shown in FIG. 15B, the rail 1307 can betranslated all the way toward the foot of the table 1301. From there,the arm 1402 can further extend longitudinally to position an instrumentbetween the legs of the patient 10 for access to the groin area.Although only one robotic arm 1402 is illustrated in FIG. 15B, in otherembodiments, multiple robotic arms, either mounted on the sameadjustable arm support 1305 or an additional arm support 1305 can beconfigured for use in an endoscopic procedure. FIG. 15B provides onlyone example of an endoscopic procedure. Systems including adjustable armsupports 1305 can be used in other types of endoscopic procedures, suchas bronchoscopy, for example.

FIG. 16 is an isometric view of a surgical robotics system 1600 with anadjustable arm support 1305 configured with a rail 1307 capable oftilting according to one embodiment. As discussed previously, an armsupport can include a second joint 1315 configured to allow the armsupport 1305 to tilt. In the illustrated embodiment of FIG. 16, thesecond joint 1315 is positioned between the carriage 1309 and the railconnector 1311, although, as discussed previously, other positions forthe second joint 1315 are possible. The second joint 1315 can berotational joint configured to rotate or provide adjustment of the armsupport 1305 about the second axis 1325. As shown in FIG. 16, byrotating or providing adjustment of the arm support 1305 about thesecond axis 1325, a tilt angle 1335 of the axis 1329 can be adjusted.The tilt angle 1335 can be measured between, for example, the axis 1329(of the rail 1307) and the x-axis, the support surface plane 1331, orthe table surface plane 1333.

In some embodiments, the second joint 1315 permits tilting of the railrelative to the table 1301. In some embodiments, the table 1301 can alsopivot or tilt (for example to a Trendelenburg position), and the secondjoint 1315 can allow the adjustable arm support 1305 to follow thepivoting or tilting of the table 1301. This can allow surgical arms 1402to remain in position a relative to the patient 10 and/or table 1301 asthe table 1301 pivots or tilts. This may be advantageous as a surgeon orclinician may desire to pivot or tilt the table 1301 intraoperatively.In some embodiments, the second joint 1315 pivots or tilts to allow therail 1307 to remain parallel with the table 1301 as the table tilts. Insome embodiments, the rail 1307 need not remain parallel with the table1301.

FIGS. 17A and 17B illustrate that systems including adjustable armsupports 1305 may provide improved access for medical imaging devices.As described above, the position of the adjustable arm support 1305 canbe adjusted so as to allow access to or accommodate a medical imagingdevice, such as a C-arm. In addition to providing improved access formedical imaging devices, the adjustable arm supports also provideimproved access for clinicians.

FIG. 17A is an isometric view of a surgical robotics system 1700A withadjustable arm supports 1305A, 1305B positioned to allow access for aC-arm 1704 of a medical imaging device 1702 according to one embodiment.As shown, the second adjustable arm support 1305B is positioned near thefloor, so as to be positioned below the C-arm 1704 of the medicalimaging device. The first adjustable arm support 1305A is positionednear the table 1301 such that the robotic arm can access the patient.

FIG. 17B is an isometric view of the surgical robotics system 1700B withthe adjustable arm supports 1305A, 1305B positioned to allow access forthe C-arm 1704 of the medical imaging device 1702 according to anotherembodiment. In the illustrated embodiment, the first adjustable armsupport 1305A is positioned near the table 1301, such that the C-arm1704 partially surrounds the first adjustable arm support 1305A.

The adjustability of the adjustable arm supports 1305 can advantageouslyallow the systems to work with will other types of medical imagingdevices as well.

FIGS. 18A and 18B illustrate that systems including adjustable armsupports 1305 can be configured to allow the adjustable arm supports1305 and corresponding robotic arms 1402 to stow conveniently below thetable 1301. This may advantageously provide that the systems are lessbulky and cumbersome than some surgical robotics systems. The adjustablearm supports 1305 can transition between a stowed configuration (FIG.18B) and a deployed configuration (FIG. 18A).

FIG. 18A is an isometric view of a surgical robotics system 1800A withan adjustable arm support 1305 positioned in a deployed configurationaccording to one embodiment. As shown, the adjustable arm support 1305has been adjusted such that the rail 1307 is positioned adjacent to aside of the table 1301, and a robotic arm 1402 has been deployed so asto access the patient 10. FIG. 18A also illustrates that the base 1303can include a recess 1337. The recess 1337 can be configured to receivethe arm support 1305 in the stowed configuration, as shown for example,in FIG. 18B.

FIG. 18B is an isometric view of a surgical robotics system 1800B withadjustable arm supports 1305A, 1305B positioned in a stowedconfiguration according to one embodiment. As shown, bar or rails 1307A,1307B of each arm support are received into recesses 1337 in the base1303. In some embodiments, the robotic arms 1402A, 1402B, 1402C can foldover the arm supports 1305A, 1305B as shown. A stowed configuration, forexample, with the arm supports 1305A, 1305B stored in recesses 1337below the table 1301, as shown in FIG. 18B, can advantageously make thesystem less bulky and cumbersome. In other embodiments, both the armsupports and robotic arms can be stored into recesses in the base 1303.While embodiments described herein illustrate an arm support in a lowposition relative to the table, in other embodiments, adjustable armsupports can be provided from an elevated or suspended position abovethe table. These adjustable arm supports in a suspended position canhave attributes similar to those that are positioned lower, includingindependent adjustability, height differential relative to one another,tilt, and longitudinal translation.

In some embodiments, systems including adjustable arm supports 1305 canbe configured to be mobile. For example, in some embodiments, the base1301 can include wheels to allow the system to be easily repositioned(see, e.g., FIG. 14A). For example, the system could have a separatetransport cart that lifts it off the floor and moves it. In someembodiments, the system is not permanently affixed in the operatingroom.

FIG. 19 is a flow chart illustrating a method 1900 for operating asurgical robotics system with adjustable arm supports according to oneembodiment. For example, the method 1900 can be used to operate any ofthe systems described above with reference to FIGS. 13A-18B. In someembodiments, the method 1900 can be stored as computer readableinstructions stored in a memory. A processor can access the memory andexecute the computer readable instructions to perform the method 1900.

The method 1900 begins at block 1902 which involves receiving a command.In some embodiments, the command is received from a physician, nurse,physician assistant, surgeon staff, etc. The command may relate to thepositioning of at least one of a first robotic arm, a medical instrumentcoupled to an end effector of the robotic first arm, and/or an armsupport coupled to a base of the first robotic arm. In some embodiments,the command may be a command to stow or deploy the system.

In some embodiments, a first command actuates the at least one joint toadjust the position of the arm support along a vertical axis of thecolumn, a second command actuates a second joint for pivoting up the armsupport, a third command actuates a third joint for tilting the armsupport and a fourth command causes longitudinal translation of the armsupport.

At block 1904, the method 1900 involves actuating at least one joint ofan adjustable arm support to adjust a position of a bar or rail of thearm support based on the received command. For example, the method 1900may actuate one or more of the first joint, the second joint, the thirdjoint, and/or the fourth joint. This may cause the arm support to movein one or more of its degrees of freedom.

The method 1900 may further include raising the arm support, the firstrobotic arm, and the second robotic arm from a stowed position below thetable; positioning the arm support, the first robotic arm and the secondrobotic arm adjacent the table; adjusting a position of the arm supportrelative to the table via at least one of the first command, secondcommand, third command, or fourth command, and adjusting a position ofthe first robotic arm relative to the second robotic arm along the railof the support joint in preparation for a surgical procedure. In someembodiments, the arm support is positioned below an upper surface of thetable.

In some embodiments, the method 1900 is executed by a controller forexecuting one or more commands based on a kinematics model, wherein theone or more commands control the positioning of one or more of the firstrobotic arm, the medical instrument coupled to an end effector of therobotic first arm; and an arm support coupled to a base of the firstrobotic arm and to a column supporting a patient-support table, whereinthe arm support comprises at least one joint and a rail configured tosupport the first robotic arm.

FIG. 20 is a block diagram of a surgical robotics system 2000 withadjustable arm supports 1305A, 1305B according to one embodiment. Asshown, the system 2000 includes a processor 2002 in communication with amemory 2004. The processor 2002 and memory 2004 can be configured toexecute, for example, the method 1900 described above.

The system also includes the table 1301. In the illustrated embodiments,two adjustable arm supports 1305A, 1305B are coupled to the table 1301.The adjustable arm supports 1305A, 1305B can be coupled to the table1301, a column 1302 supporting a table, or a base 1303 supporting thecolumn. Each of the adjustable arm supports 1305A, 1305B is incommunication with the processor 2002 such that the process can adjustthe position of the adjustable arm supports 1305A, 1305B.

In the illustrated embodiment, a set of robotic arms is attached to eachof the adjustable arm supports 1305A, 1305B. For example, robotic arms1402A, 1402B are coupled to adjustable arm support 1305A, and roboticarms 1402C, 1402D are coupled to adjustable arm support 1305B. In otherembodiments, other numbers of robotic arms (e.g., one, three, four,etc.) can be coupled to each arm support 1305A, 1305B. Example roboticarms are described in section XIII below. In some embodiments, as thearm supports support multiple robotic arms, the stiffness of the armsupports can be increased. This increased stiffness provides an addedbenefit of stability when used with multiple arms, as this can reducethe shaking of the robotic arms during a surgical process.

In some embodiments, the processor 2002 is configured to executeinstructions stored in the memory 2004 to adjust a position of the baror rail along the first axis in response to receiving a command. Thecommand can comprise a command to adjust a position of a robotic medicaltool coupled to a robotic arm coupled to the arm support. In someembodiments, the processor 2002 is further configured to execute theinstructions to cause the system to at least adjust a position of a railor the arm supports 1305A, 1305B in response to a physician selectedprocedure. In some embodiments, the processor 2002 is further configuredto execute the instructions to cause the system 2000 to at least adjusta position of the rail to avoid a collision between the robotic arm andat least one of: the table, a patient, an additional robotic arm, and amedical imaging device. The system 2000 may further be configured toavoid collision with other items in the environment of the system, suchas, pendants, stirrups, things that clip onto the bed rail, a nurse,etc.). In addition to collision avoidance, the processor 2002 canfurther be configured to adjust the position of the arm supports 1305A,1305B to optimize pose or improve manipulability of the robotic arms1402A, 1402B, 1402C, 1402D.

XIII. Robot Arms Associated with Adjustable Arm Supports

The adjustable arm supports described above can be configured to mountto the table, the column, or the base, and are adjustable (moveable invarious degrees of freedom) to support robotic arms positioned on theadjustable arm supports. As the adjustable arm supports can beconfigured to mount below the surface of the table in accordance withsome embodiments, it can be advantageous to employ certain types ofrobotic arms with the adjustable arm supports. In particular, robot armsthat have increased movement and flexibility may be desirable, as therobot arms may have to “work up” from a lower position and avoidcollisions (e.g., with the table). This section outlines certainfeatures of robotic arms configured for use with adjustable armsupports.

For example, in some embodiments, robotic arms configured for use withthe adjustable arm supports differ from parallelogram remote centerrobotic arms. In one example, a robotic arm configured for use with theadjustable arm supports can comprise a shoulder with at least twodegrees of freedom, an elbow with at least one degree of freedom, and awrist with at least two degrees of freedom. The kinematics associatedwith such an arm allow the arm base to be positioned arbitrarilyrelative to the workspace, allowing for setups that would be challengingfor a parallelogram remote center robot mounted alongside a bed.

Further, in some embodiments, a robotic arm configured for use with theadjustable arm supports may include a semi-spherical or spherical wristconfigured with at least three degrees of freedom. Such a wrist canallow the robotic arm to roll its wrist joint such that an instrumentdrive mechanism positioned at the distal end of the robotic arm can bebelow the arm wrist. This can enable procedures where target workspacesare far above ports.

Some surgical robotic arms include a mechanically constrained remotecenter with no redundant degrees of freedom (e.g., parallelogram roboticarms). That is, for any remote center position, the distance to the baseis mechanically constrained. Robotic arms coming from below the bed, asis the case with robotic arm mounted on the adjustable arm supportsdescribed above, can be limited by their mount structures and cannotreach the optimal configurations to make parallelogram robot arms excel.To address this issue, robotic arms configured for use with theadjustable arm supports described above can include one or moreredundant degrees of freedom. The redundant degrees of freedom can allowthe arms to be jogged within their null space without moving the tooltip, allowing for intraoperative collision avoidance that is notpossible previously known surgical robotic arms.

FIG. 21 is an isometric view of a robotic arm 2100, according to oneembodiment, which may be configured to provide one or more of thefeatures or advantages described above. The robotic arm 2100 can beconfigured for use with the adjustable arm support(s) 1305 describedabove. The robotic arm 2100 may comprise a plurality of componentsarranged serially. The components can be connected by one or more joints(e.g., motorized or hydraulic joints) configured to allow movement orarticulation of the robotic arm 2100. As illustrated, for someembodiments, the joints can be grouped into the shoulder 2117, the elbow2119, and the wrist 2121.

In the illustrated example, the shoulder 2117 includes three joints, theelbow 2119 includes one joint, and the wrist 2121 includes two joints.Stated another way, in some embodiments, one or more of the shoulder2117, the elbow 2119, or the wrist 2121 can provide more than one degreeof freedom for the robotic arm 2100. In the illustrated embodiment, theshoulder 2117 is configured to provide three degrees of freedom, theelbow 2119 is configured to provide one degree of freedom, and the wrist2121 is configured to provide two degrees of freedom. In otherembodiments, the shoulder 2117, the elbow 2119, or the wrist 2121 can beconfigured with other numbers of joints and/or to provide other numbersof degrees of freedom.

The shoulder 2117 can be located generally at a proximal portion 2101 ofthe robotic arm 2100. The wrist 2121 can be located generally at adistal portion 2103 of the robotic arm 2100. The elbow 2119 can belocated generally between the proximal portion 2101 and the distalportion 2103. In some embodiments, the elbow 2119 is located between aproximal link 2109 and a distal link 2111. In some embodiments, therobotic arm 2100 can include other joints or regions of joints thanthose illustrated in FIG. 21. For example, the robotic arm 211 couldinclude a second elbow (comprising one or more joints) between the elbow2119 and the wrist 2121 and/or between the elbow 2110 and the shoulder2117.

The shoulder 2117, elbow 2119, and wrist 2121 (and/or other joints orcomponents of or associated with the robotic arm) can provide variousdegrees of freedom. For the illustrated embodiment, the degrees offreedom are illustrated with arrows. The arrows are intended to indicatethe motions provided by each degree of freedom. The illustratedembodiment includes the following degrees of freedom. Not all degrees offreedom need be included in all embodiments, and in some embodiments,additional degrees of freedom can be included. The joints providing thevarious degrees of freedom can be powered joints, such as motorizedjoints or hydraulically powered joints, for example.

As illustrated, the robotic arm 2100 includes a degree of freedompermitting shoulder translation. The robotic arm 2100 can also include adegree of freedom permitting shoulder yaw. The robotic arm 2100 can alsoinclude a degree of freedom permitting shoulder pitch. The robotic arm2100 can also include a degree of freedom permitting elbow pitch. Therobotic arm 2100 can also include a degree of freedom permitting wristyaw. The robotic arm 2100 can also include a degree of freedompermitting wrist pitch. The robotic arm 2100 can also include a degreeof freedom permitting instrument driver roll. This degree of freedom canbe configured allow an instrument attached to the instrument driver (orthe instrument driver itself) to be rolled around its axis.

An insertion degree of freedom can also be associated with the roboticarm 2100. The insertion degree of freedom can be configured to permitinsertion (or retraction) of the instrument (or tool) attached to aninstrument driver mechanism 2115 along an axis of the instrument or anaxis of the instrument driver 2115.

These and other features of robotic arms configured for use with theadjustable arms supports 1305 described above are described in greaterdetail in the application entitled “Surgical Robotics System” filed oneven date herewith.

XIV. Software

In some embodiments, one or more aspects of a system includingadjustable arm supports and corresponding robotic arms can be controlledvia software. For example, the system can be designed so that allactuations are robotically controlled by the system, and the systemknows the position of all end effectors relative to the tabletop. Thismay provide a unique advantage that existing robotic surgery systems donot have. Further, this may allow for advantageous workflows including:adjusting the table top intraoperatively (e.g., tilt, Trendelenburg,height, flexure, etc.) while arms and arm positioning platforms move insync; moving the robotic arms can move away from the operative field fordraping or patient loading; after a clinician tells the system the typeof procedure, the robotic arms can move to approximate positions nearwhere ports are typically placed (Surgeons could modify and set portselection “presets” for how they like to do surgery); and performing“last mile” docking with cameras on the end effectors and vision targetson cannulas (other non-optical sensors around the end effector couldprovide similar functionality).

Further, some incarnations of robotic arm joints may require applyinghigh forces to the arm to back-drive the motors and transmissions. Thiscan be reduced with torque sensors in arm joints or a force sensor orjoystick at the end effector to allow the robot to know where theclinician is trying to push it and move accordingly (admittance control)to lower back-drive forces felt at the output. Such back-driveregulation can be accomplished in software in some embodiments.

XV. Additional Considerations

Upon reading this disclosure, those of skill in the art will appreciatestill additional alternative structural and functional designs throughthe disclosed principles herein. Thus, while particular embodiments andapplications have been illustrated and described, it is to be understoodthat the disclosed embodiments are not limited to the preciseconstruction and components disclosed herein. Various modifications,changes and variations, which will be apparent to those skilled in theart, may be made in the arrangement, operation and details of the methodand apparatus disclosed herein without departing from the spirit andscope defined in the appended claims.

As used herein any reference to “one embodiment” or “an embodiment”means that a particular element, feature, structure, or characteristicdescribed in connection with the embodiment is included in at least oneembodiment. The appearances of the phrase “in one embodiment” in variousplaces in the specification are not necessarily all referring to thesame embodiment.

Some embodiments may be described using the expression “coupled” and“connected” along with their derivatives. For example, some embodimentsmay be described using the term “coupled” to indicate that two or moreelements are in direct physical or electrical contact. The term“coupled,” however, may also mean that two or more elements are not indirect contact with each other, but yet still co-operate or interactwith each other. The embodiments are not limited in this context unlessotherwise explicitly stated.

As used herein, the terms “comprises,” “comprising,” “includes,”“including,” “has,” “having” or any other variation thereof, areintended to cover a non-exclusive inclusion. For example, a process,method, article, or apparatus that comprises a list of elements is notnecessarily limited to only those elements but may include otherelements not expressly listed or inherent to such process, method,article, or apparatus. Further, unless expressly stated to the contrary,“or” refers to an inclusive or and not to an exclusive or. For example,a condition A or B is satisfied by any one of the following: A is true(or present) and B is false (or not present), A is false (or notpresent) and B is true (or present), and both A and B are true (orpresent).

In addition, use of the “a” or “an” are employed to describe elementsand components of the embodiments herein. This is done merely forconvenience and to give a general sense of the invention. Thisdescription should be read to include one or at least one and thesingular also includes the plural unless it is obvious that it is meantotherwise.

What is claimed is:
 1. A system, comprising: a table configured tosupport a patient; a column extending along a first axis between a firstend and a second end, the first end coupled to the table; a base coupledto the second end of the column; and a first arm support coupled to atleast one of the table, column or the base by at least a first jointconfigured to allow adjustment along the first axis relative to thetable, the first arm support comprising a first bar having a proximalportion and a distal portion extending along a second axis differentfrom the first axis, the first bar configured to support at least onerobotic arm.
 2. The system of claim 1, wherein the first axis is avertical axis and the first joint is configured to allow adjustment ofthe first bar in a vertical direction.
 3. The system of claim 1, whereinthe first joint comprises a motorized linear joint configured to movealong the first axis.
 4. The system of claim 1, further comprising afirst robotic arm mounted to the first bar, the first robotic armconfigured to translate along the second axis.
 5. The system of claim 4,further comprising a second robotic arm mounted to the first bar, thesecond robotic arm configured to translate along the second axis.
 6. Thesystem of claim 5, wherein the second robotic arm is configured totranslate along the second axis independently of the first robotic arm.7. The system of claim 5, further comprising a third robotic arm mountedto the first bar.
 8. The system of claim 7, wherein at least one of thefirst robotic arm, second robotic arm or third robotic arm holds acamera.
 9. The system of claim 1, wherein the first arm supportcomprises a second joint configured to adjust a tilt angle of the firstbar.
 10. The system of claim 1, wherein the first bar is capable oftranslation along a length of the table such that the first bar canextend beyond an end of the table.
 11. A system, comprising: a tableconfigured to support a patient; a column extending along a first axisbetween a first end and a second end, the first end coupled to thetable; a base coupled to the second end of the column; a first armsupport comprising a first bar having a proximal portion and a distalportion extending along a second axis, the first bar coupled to at leastone of the table, column or base by at least a first joint configured toallow adjustment of the first bar along the first axis, the first armsupport configured to support at least one robotic arm; and a second armsupport comprising a second bar having a proximal portion and a distalportion extending along a third axis coupled to the column by at least asecond joint configured to allow adjustment of the second bar along thefirst axis, the second arm support configured to support at leastanother robotic arm; wherein the first arm support and the second armsupport are configured such that the position of the first bar and thesecond bar along the first axis can be adjusted independently.
 12. Thesystem of claim 11, wherein the first axis is a vertical axis, the firstjoint is configured to allow adjustment of the first bar in a verticaldirection, the second joint is configured to allow adjustment of thesecond bar in the vertical direction, and wherein the first bar and thesecond bar can be adjusted to different heights.
 13. The system of claim11, wherein the first arm support is configured to be positioned on afirst side of the table, and the second arm support is configured to bepositioned on a second side of the table.
 14. The system of claim 13,wherein the second side is opposite the first side.
 15. The system ofclaim 11, wherein: the first arm support comprises a third jointconfigured to adjust a tilt angle of the second axis of the first barrelative to the surface of the table; and the second arm supportcomprises a fourth joint configured to adjust a tilt angle of the thirdaxis of the second bar relative to the surface of the table.
 16. Thesystem of claim 15, wherein the tilt angle of the first bar axis and thetilt angle of the second bar axis can be adjusted independently.
 17. Thesystem of claim 11, wherein the first and second arm supports areconfigured to be stored below the table.
 18. The system of claim 11,wherein one or more of the first joint and the second joint, aremotorized or controlled by hydraulics.
 19. The system of claim 11,wherein the first arm support supports at least two robotic arms thatare linearly translatable relative to one another.
 20. The system ofclaim 11, further comprising multiple robotic arms on the first armsupport and multiple arms on the second arm support, wherein the numberof arms on the first arm support is equal to the number of arms on thesecond arm support.